Bahnini A, Bailly M, Chiche L, Franceschi C
Service de Chirurgie Vasculaire, Groupe Hospitalier Pitié-Salpêtrière.
Ann Chir. 1997;51(7):749-60.
Ambulatory conservative haemodynamic correction of venous insufficiency (CHIVA) is a surgical treatment of superficial venous insufficiency designed to correct the pathological haemodynamic effects of superficial venous insufficiency apparent on standing. Surgical treatment is based on precise preoperative anatomical and haemodynamic mapping performed by duplex ultrasound, providing preoperative ultrasound-guided marking. Surgical treatment consists of dividing the hydrostatic pressure column and disconnecting venovenous shunts by ligation-section of the superficial venous network at precise points determined by the preoperative ultrasound-guided marking. This strategy should achieve a superficial venous circuit draining perfectly into the competent deep venous network. The operation is performed under local anaesthesia as an outpatient procedure and allows immediate resumption of walking, which promotes a good result due to activation of the calf muscle pump. The results of the technique are very good provided a reliable preoperative ultrasound-guided marking and a precise surgical procedure are performed. Failures are due to poor haemodynamic assessment or inappropriate surgical procedure.
门诊保守性静脉功能不全血流动力学矫正术（CHIVA）是一种针对浅表静脉功能不全的外科治疗方法，旨在矫正站立时明显的浅表静脉功能不全的病理血流动力学效应。手术治疗基于术前通过双功超声进行的精确解剖和血流动力学绘图，并提供术前超声引导标记。手术治疗包括在术前超声引导标记确定的精确位置，通过结扎浅表静脉网络的分段来划分静水压柱并断开静脉分流。该策略应实现浅表静脉回路完美引流至功能正常的深静脉网络。手术在局部麻醉下作为门诊手术进行，术后可立即恢复行走，由于小腿肌肉泵被激活，这有助于取得良好效果。如果进行可靠的术前超声引导标记和精确的手术操作，该技术的效果非常好。失败原因是血流动力学评估不佳或手术操作不当。
