CHIVA (from French «Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire») means «Conservative and hemodynamic outpatient treatment of venous insufficiency».
This treatment method is grounded on the concept that varices themselves are not a disease, but the consequence of blood circulation disturbance which overcharges veins (usually one of saphenous veins). Therefore, a minimally invasive operation is performed only for the elimination of elevated pressure mechanism, without eliminating the vein itself which remains.
The procedure involves pre-operation marking of the skin with a pen grounded on duplex sonography. This is performed in order to find sites for surgical intervention. Then, usually under local anaesthesia, the veins in those sites where there is valve insufficiency, are closed, and this makes blood find other appropriate ways of circulation (Picture 1). This is much alike closing several possible ways out of a maze, having only the easiest and the fastest way open.
However, the dilated vein (trunk of great and/or small saphenous vein) is not ejected. This makes the operation less aggressive, and it can be performed without hospitalization, with a short-term recovery period.
Plan of performing CHIVA
Red colour marks blood flow disturbance in the extremity; green colour marks sites of incisions and varicose vein ligation; violet colour marks removal of varicose veins from the abnormal blood flow, with the aim of normalization of blood flow in the extremity.
This method of treatment is practised by Professor Dmytro Riazanov, Doctor of Medicine, who is extensively experienced in treating patients with lower extremity varicose vein disease.
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