Clinical Results of a New Strategy (Modified CHIVA) for Surgical Treatment of Anterior Accessory Great Saphenous Varicose Veins

Maldonado-Fernández, N.; Palomino, J.P. Linares; López-Espada, C.; Martínez-Gámez, Francisco Javier; Ros-Díe, E.

doi:10.1016/j.cireng.2016.02.020

Cited by 5 publications

(6 citation statements)

References 20 publications

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“…The mean diameter of the AASV significantly reduced (from 6.4 to 3.4 mm) and AASV reflux was abolished in 82% of treated limbs. 305 The treatment strategy for patients with AASV incompetence is summarised in Fig. 9.…”

Section: Classmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs

Maeseneer¹,

Kakkos²,

Aherne³

et al. 2022

European Journal of Vascular and Endovascular Surgery

376

110

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Section: Classmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs

Maeseneer¹,

Kakkos²,

Aherne³

et al. 2022

European Journal of Vascular and Endovascular Surgery

376

110

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“…The baseline CEAP clinical classification was: 58% C2, 26% C3 and 15% C4–6. 87 Disconnection of the varicose veins from the AASV with extensive phlebectomy with multiple incisions was performed. The CHIVA-method is based on the theory that removal of the side-branches of the truncal veins will abolish the reflux in the truncal vein.…”

Section: Resultsmentioning

confidence: 99%

“…The non-pooled anatomic success rate was 97.9% at 24 months after phlebectomy and 82% at 12 months after the CHIVA procedure. 85,87…”

Section: Discussionmentioning

confidence: 99%

“…The nonpooled anatomic success rate was 97.9% at 24 months after phlebectomy and 82% at 12 months after the CHIVA procedure. 85,87 The available AASV data remains heterogeneous regarding the technical procedure. ETA shows a high pooled anatomic success rate, however, the mean follow-up was relative short.…”

Section: Discussionmentioning

confidence: 99%

“…The VCSS, postprocedural pain, and time to return to daily activities after EVLA were assessed by Cavallini et al 76 Symptoms and esthetic outcome were only assessed after CHIVA. 87 However, these outcome measures are of importance as EVLA of the small saphenous vein (SSV) showed a higher success rate, fewer complications, and earlier return to work compared with surgery but no significant differences in quality of life measures. 94 The risk of paresthesia may be an important limitation of ETA of AASV due to anatomy.…”

Section: Discussionmentioning

confidence: 99%

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A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

et al. 2021

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Objective To investigate and compare the outcomes of the available treatment modalities for anterior accessory saphenous vein (AASV) incompetence. Methods A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Studies reporting the outcomes of patients who were treated for primary AASV incompetence were included. The methodologic quality of the articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). A random-effects model was used to estimate anatomic success, defined as AASV occlusion. The secondary outcomes were pain during and after treatment, venous clinical severity score, quality of life, esthetic result, time to return to daily activities, and complications. Results The search identified 860 articles, of which 16 met the inclusion criteria. A total of 609 AASVs were reported. The included studies were of poor or moderate quality according to MINORS score. The pooled anatomic success rates were 91.8% after endovenous laser ablation and radiofrequency ablation (EVLA, RFA, 11 studies), 93.6% after cyanoacrylate closure (3 studies), and 79.8% after sclerotherapy (2 studies). The non-pooled anatomic success rate was 97.9% after phlebectomy and 82% after CHIVA. Paresthesia was seen after EVLA in 0.7% of patients (6 studies). Phlebitis was seen in 2.6% of patients after RFA (2 studies), 27% after sclerotherapy (1 study), and 12% after the phlebectomy (1 study). Deep venous thrombosis and skin burn did not occur. Conclusion Treatment of AASV incompetence is safe and effective. Despite limited evidence, occlusion of the AASV can be achieved with endovenous thermal ablation and cyanoacrylate. There does not appear to be a benefit of EVLA compared to RFA regarding treatment efficacy. Phlebectomy shows promising results if the saphenofemoral junction is competent. Lower results are seen after sclerotherapy and CHIVA. However, studies with sufficient sample sizes of solely treatment of AASV incompetence are needed to draw firm conclusions.

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CHIVA method for the treatment of chronic venous insufficiency

Bellmunt-Montoya

Escribano

Pantoja

et al. 2021

Cochrane Database of Systematic Reviews

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Clinical Results of a New Strategy (Modified CHIVA) for Surgical Treatment of Anterior Accessory Great Saphenous Varicose Veins

Cited by 5 publications

References 20 publications

Editor's Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs

Editor's Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs

A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

CHIVA method for the treatment of chronic venous insufficiency

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