CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report

Faccini, Felipe Puricelli; Arendt, Ani Loize; Pereira, Raphael Quintana; Oliveira, Alexandre Roth de

doi:10.1590/1677-5449.007718

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…In terms of superficial venous reflux velocity, it is also confirmed once again that CHIVA can retain the advantage of perforating veins and better improve the positive blood flow of lower extremity veins. [27,28] In this meta-analysis, CHIVA technology showed some advantages in the incidence of complications. The overall incidence of complications of CHIVA was lower than that of HLS, and the incidence of DVT, postoperative sensory disturbance, hematoma and ecchymosis was lower than that of HLS.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis

Pei,

Li,

Niu

et al. 2023

Medicine

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Objective: Systematic evaluation of the efficacy and safety of conservative hemodynamic cure for venous insufficiency (CHIVA) compared with high ligation and stripping (HLS) in the treatment of varicose veins of lower extremities. Methods: We conducted a systematic literature search and compared the randomized controlled trial and retrospective cohort study of CHIVA and HLS in the treatment of varicose veins of lower extremities in several databases, including China National Knowledge Infrastructure, Wanfang database, cqvip datebase, PubMed, Cochrane library and EMBASE, to identify articles that might meet the criteria. Meta-analysis was performed using Revman 5.3 and Stata 13.0 software. Results: This Meta-analysis included a total of 14 research articles. This meta-analysis shows that CHIVA requires shorter operation time than HLS [mean difference (MD) = −13.57, 95% confidence interval (CI) (−21.05, −6.10), P = .0004]. There is less blood loss with CHIVA surgery [MD = −21.72, 95% CI (−30.35, −13.09), P < .00001]. The number of incisions made by the CHIVA technique is less [MD = −3.67, 95% CI (−4.03, −3.31), P < .00001]. Patients who underwent CHIVA had a shorter hospital stay [MD = −3.40, 95% CI (−4.72, −2.09), P < .00001]. The relapse rate was lower after CHIVA [OR = 0.36, 95% CI (0.18, 0.70), P = .003]. In terms of postoperative complications, CHIVA has a lower total complication rate [MD = 0.26, 95% CI (0.15, 0.46), P < .00001]. The incidence of deep vein thrombosis was lower after CHIVA [MD = 0.23, 95% CI (0.06, 0.92), P = .04]. CHIVA has a lower incidence of sensory disturbance than HLS [OR = 0.39, 95% CI (0.25, 0.60), P < .0001]. CHIVA technique has less nerve injury rate than HLS [OR = 0.11, 95% CI (0.02, 0.62), P = .01]. The incidence of hematoma was lower after CHIVA [OR = 0.48, 95% CI (0.27, 0.87), P = .02]. Among other metrics, the comparison results of the 2 techniques were similar. Conclusion: By comparison, it is found that CHIVA has shorter operation time, less blood loss, and fewer surgical incisions. Patients who underwent CHIVA surgery had shorter hospital stays and lower relapse rates. In terms of complications, the incidence of total complications after CHIVA is lower, and the incidence of postoperative deep vein thrombosis, postoperative sensory, nerve injury, and postoperative hematoma is also lower than that of HLS.

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Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis

Pei,

Li,

Niu

et al. 2023

Medicine

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“…CHIVA is ambulatory conservative hemodynamic management of varicose veins that preserves deliberately the saphenous vein and collaterals based on venous hemodynamics[ 22 ]. CHIVA is an office-based treatment for varicose veins performed under local anesthesia.…”

Section: Chivamentioning

confidence: 99%

Strategies and challenges in treatment of varicose veins and venous insufficiency

Gao¹,

Qian²,

Wang³

et al. 2022

WJCC

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Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences. In the recent decade, the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques. The literature was systematically searched on Medline without language restrictions. All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed. Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) both are same safe and effective in terms of occlusion rate, and time to return to normal activity. In comparison with RFA or EVLT, Cure conservatrice et Hemodynamique de l'Insufficience Veineuse en Ambulatoire (CHIVA) may cause more bruising and make little or no difference to rates of limb infection, superficial vein thrombosis, nerve injury, or hematoma. In terms of recurrence of varicose veins, there is little or no difference between CHIVA and stripping, RFA, or EVLT. Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy (FS) group (51%) during 1 year of follow-up. The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy. Although the mechanochemical endovenous ablation (MOCA) is a non-thermal, non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage, the overall success rate of MOCA is lower than those of other procedures such as EVLA, RFA, or high ligation and stripping. EVLA is the most cost-effective therapeutic option, with RFA being a close second for the treatment of patients with varicose veins. Endovenous thermal ablation (EVLA or RFA) is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins. Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures. MOCA and cyanoacrylate embolization appear promising, but evidence of their effectiveness is required.

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Evolução e qualidade de vida em pós-operatório de cirurgia vascular

Mendes¹,

Araújo²,

Lima³

et al. 2021

RSD

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Este estudo tem como objetivo analisar e avaliar a qualidade de vida na recuperação de pacientes no período de pós-operatório em cirurgias vasculares. Métodos: trata-se de uma revisão de literatura integrativa, a qual se realizou uma pesquisa bibliográfica nas seguintes bases de dados, selecionadas através do metabuscador do Portal Periódico CAPES: Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrievel System Online (Medline) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), utilizando os descritores “Cirurgia vascular”, “Pós-operatório” e “Qualidade de vida”, que foram pesquisados nos Descritores em Ciências da Saúde (DECs). Após a leitura analítica, apenas 14 artigos atenderam aos critérios de inclusão e foram utilizados para compor a amostra final deste estudo. Foram utilizados os artigos que estivessem enquadrados como estudos com seres humanos e publicados entre 2010 e 2020. Resultados: a técnica cirúrgica tem grande influência na evolução do quadro clínico do paciente. Novas técnicas surgem com o objetivo de ser menos invasivas e proporcionarem uma melhor recuperação. Porém, algumas patologias, por serem graves, ainda apresentam uma alta taxa de mortalidade e complicações. Conclusão: Pacientes acometidos por doenças vasculares necessitam de um cuidado especial no intuito de evitar complicações no pós-operatório e garantir uma boa qualidade de vida. Observou-se que além da gravidade da doença, a avaliação da realidade que o paciente está inserido tem importância considerável na qualidade de vida, uma vez que os fatores biopsicossociais impactam de forma significativa no processo de adoecimento.

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CHIVA to spare the small and great saphenous veins after wrong-site surgery on a normal saphenous vein: a case report

Cited by 4 publications

References 12 publications

Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis

Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis

Strategies and challenges in treatment of varicose veins and venous insufficiency

Evolução e qualidade de vida em pós-operatório de cirurgia vascular

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