Zamboni P, Marcellino M G, Feo C, Berta R, Vasquez G, Pansini G C
Institute of General Surgery and Vascular Laboratory, University of Ferrara, Italy.
Dermatol Surg. 1995 Jul;21(7):621-5. doi: 10.1111/j.1524-4725.1995.tb00518.x.
Hemodynamic correction (CHIVA) is a conservative, ambulatory, and controversial varicose vein treatment. It consists of selected ligatures of the superficial venous system decided by means of preoperative duplex mapping.
Prospective evaluation of 80 patients, operated on according to the CHIVA technique described by Claude Franceschi. Mean follow-up length was 30 months.
Fifty-five consecutive patients were operated on after clinical, ultrasonographic, ambulatory venous pressure and light reflection rheography evaluations. After a 3-year follow-up, another 25 consecutive patients were selected applying some exclusion criteria that emerged in the first part of the study. This second series was operated on by means of intraoperative angioscopy. The same preoperative evaluations have been used to study the outcome in all patients.
CHIVA failed in the short saphenous vein territory varices and when the long saphenous vein and the insufficient perforating veins had a preoperative diameter greater than 10 and 4 mm, respectively. The procedure showed a long saphenous vein patency of 90.4% and registered a total recurrence rate of 18.7%.
CHIVA seems to be a more effective varicose vein treatment than high ligation and distal stab avulsion. It also preserves a higher rate of long saphenous veins, suitable for bypass surgery.
血流动力学纠正（CHIVA）是一种保守、非卧床且存在争议的静脉曲张治疗方法。它包括通过术前双功超声造影确定对浅静脉系统进行选择性结扎。
对80例按照克洛德·弗朗切斯基描述的CHIVA技术进行手术的患者进行前瞻性评估。平均随访时长为30个月。
在进行临床、超声、动态静脉压及光反射血流图评估后，对55例连续患者进行手术。经过3年随访后，根据研究第一部分中出现的一些排除标准，又选取了25例连续患者。第二组患者通过术中血管内镜进行手术。所有患者均采用相同的术前评估来研究结果。
在小隐静脉区域的静脉曲张以及大隐静脉和功能不全的穿通静脉术前直径分别大于10毫米和4毫米时，CHIVA手术失败。该手术显示大隐静脉通畅率为90.4%，总复发率为18.7%。
CHIVA似乎是一种比高位结扎和远端挑出撕脱术更有效的静脉曲张治疗方法。它还保留了更高比例的适合用于旁路手术的大隐静脉。
