CHIVA to treat saphenous vein insufficiency in chronic venous disease: characteristics and results

Faccini, Felipe Puricelli; Ermini, Stefano; Franceschi, C.

doi:10.1590/1677-5449.009918

Cited by 20 publications

(17 citation statements)

References 29 publications

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“…15,16 In another study, the CHIVA technique was even superior to -up in which it was associated with less recurrence than the stripping technique. 17 After saphenous vein stripping, saphenous nerve injury is reported at rates from 27% to 40% .18 Despite In this study, the recurrence rate after 12 weeks of surgery was not statistically significantly different in group A (with stripping) against group B (without stripping) (p-value=0.494). Sarin and coworkers favored stripping in terms of recurrence rate (83% vs. 35%) while Winterborn and colleagues compared ligation (and avulsion) only versus the stripping group and found no significant difference in terms of recurrence (29% vs. 11%).…”

Section: Discussionmentioning

confidence: 56%

The outcome of the Trendelenburg procedure with stripping vs. no stripping in the management of varicose veins

Mohsin

Janjua

Fatima³

et al. 2020

J Fatima Jinnah Med Univ

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Background: Varicose veins is a common problem in Pakistan with multiple treatment options. One of its recommended and commonly performed surgical treatment includes the flush ligation of Saphenofemoral junction (Trendelenburg procedure) with stripping of great saphenous vein and avulsion of varicosities which is a cumbersome process. This study aims to evaluate the effect of stripping of great saphenous vein on the recurrence rate. Patients and methods: A randomized controlled trial was conducted in the Surgical Unit I, Services Hospital, Lahore over a period of 22 months from 20-09-2016 to 20-07-2018. Seventy patients were divided equally into two groups of 35 patients each i.e. Trendelenbrug procedure and avulsion of varicosities with stripping down to the knee, (Group A) versus Trendelenbrug procedure and avulsion of varicosities without stripping (Group B). Recurrence at 12 weeks was noted. SPSS version 17.0 was used to analyze data. Comparison of recurrence and stratified confounding factors such as age, gender, and BMI were assessed by the chi-square test (significant p-valve ≤0.05). Results: In group A, 32 out of 35 patients were male (91.43%) and 3 (8.57%) were female. While in group B, 31 out of 35 patients were male (88.87%) and 4 (11.43%) were female. Four out of 35 (11.43%) patients in group A whereas 6 (17.14%) group B patients (p-value=0.494) had a recurrence in the perforators below the knee at 12 weeks. Stratification (p-values) of recurrence rate with respect to age (<40 years: 0.41 versus ≥ 40 years:0.905), gender (female: p-value not applicable versus male: 0.96) and BMI was done (<25 kg/m2: 0.36 versus ≥ 25 kg/m2: 0.901) Conclusions: Stripping does not significantly affect the outcome of varicose vein surgery in relation to the recurrence rate at 12 weeks and recurrence was independent of age, gender, and BMI of patients.

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Section: Discussionmentioning

confidence: 56%

The outcome of the Trendelenburg procedure with stripping vs. no stripping in the management of varicose veins

Mohsin

Janjua

Fatima³

et al. 2020

J Fatima Jinnah Med Univ

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“…In this way, GSV segment distal to the ablated part remained patent and allows the retrograde draining toward a re-entry perforator located distally on the same GSV [11][12][13][14] (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Segmental saphenous ablation for chronic venous disease treatment

et al. 2020

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Background Endovenous thermal ablation for chronic venous disease treatment is recommended over traditional surgery. The present investigation compares endovenous laser ablation (EVLA) with radiofrequency (RF) for segmental endovenous sapheno–femoral junction ablation. Methods This is a retrospective study in which 79 patients underwent a 6 cm great saphenous vein ablation by RF or by EVLA. Primary outcome was occlusion rate. Secondary outcomes included Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) score, peri-procedural pain, aesthetic satisfaction. Results At 12 ± 1 months recanalization of shrunk tract was recorded in 5/85 (5.8%) cases (2 RF, 3 EVLA) [OR: 1.6; 95%CI: 0.2–10.4; P = 0.6689]. Two cases (1/44 RF group and 1/38 EVLA group) also showed reflux recurrence [OR: 1.0; 95%CI: 0.06–17.8; P = 1.0000]. No significant differences between groups were found in AVVQ, VCSS, peri-procedural pain, or aesthetic satisfaction. Conclusion Saphenous sparing is feasible and effective by means of both EVLA and RF, representing a possible alternative to surgery.

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“…Conservative surgery such as CHIVA (Conservatrice Hémodynamique de l'Insuffisance Veineuse en Ambulatoire / ambulatory conservative hemodynamic treatment venous insufficiency) 49 , Muller Phlebectomy and ASVAL (ablation under local anesthesia) 50 added a new perspective for eliminating reflux, sparing the main saphenous trunks with fewer nerve injuries. Also, the patient warns the doctor if a nerve is touched and it makes it hard to cause injury 51 .…”

Section: Local Anesthesia Methodsmentioning

confidence: 99%

Nerve Injury in venous procedures: Malpractice, characteristics, and strategies to avoid it

Arendt

Faccini

2018

JTAVR

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Nerve damage is the most important reason for malpractice claims after venous procedures. The incidence of nerve damage varies according to the technique and 4% to 23% present symptoms of nerve damage after varicose vein operations. The knowledge about nerve physiology and anatomy, proper preoperative ultrasound planning, clear communication, safe operation protocols, and good clinical records are pivotal to avoid such complications. Even so, there is no guarantee that a lesion will not occur. Nerve damage can happen with the best surgeons. The purpose of this paper is to review nerve physiology and its anatomy in relation to saphenous veins, to relate the incidence of nerve injury to each surgical technique and to outline strategies to prevent and treat this complication.

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CHIVA to treat saphenous vein insufficiency in chronic venous disease: characteristics and results

Cited by 20 publications

References 29 publications

The outcome of the Trendelenburg procedure with stripping vs. no stripping in the management of varicose veins

The outcome of the Trendelenburg procedure with stripping vs. no stripping in the management of varicose veins

Segmental saphenous ablation for chronic venous disease treatment

Nerve Injury in venous procedures: Malpractice, characteristics, and strategies to avoid it

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