Surgical techniques used for dealing with varicose veins have been practised over 150 years, typically involving stripping of the “saphenous vein” – the main superficial vein prone to becoming varicose. Less drastic techniques have been developed, such as ambulatory phlectomy and a procedure known as CHIVA. These are all invasive surgical procedures and the modern trend has been to develop and adopt non-invasive techniques, such as ultrasound sclerotherapy and endovenous laser ablation.

Stripping of the Saphenous Vein

The saphenous vein is the superficial vein (superficial means it can be seen) of the lower limbs and this is the vein which is typically involved with varicose vein sufferers. Stripping consists of removing the main truck of the saphenous vein from the affected leg or legs. While this has a high reported degree of success there are issues with performing this procedure in patients.

The first issue is that as the main trunk of the saphenous vein is completely removed, if the patient is to suffer a coronary event which requires replacement of parts of the vessels associated with the heart, then the saphenous vein components which would typically be used are no longer available.

A further issue is concerned with post-operative infection, which affects approximately 1 in 50 patients. Of even greater concern are the risks associated with deep vein thrombosis which affects approximately 5% of patients, and there is a lesser rick of pulmonary embolism affecting a very minor (0.6%) of patients.

Chiva

CHIVA is a French acronym (Conservatrice et Hemodynamique de l’Insufficiance Veineuse en Ambulatoire – a French medical paper dealing with blood, veins and ambulatory issues).

The principal concept behind CHIVA is that varicose veins are themselves symptomatic of abnormalities within the venous system. Hemodynamics, a term which refers to the behavior of the blood itself and its effect on the veins, is frequently cited as being the primary determinant of treatment. Varicose veins may usually occur as a consequence of the vein valves becoming open (or dilated) not just because of being overloaded (which is the most usual cause) but because of a blockage by blood clotting (known as a thrombosis blockage), or by other blockage such as a growth (or fistula).

Accordingly, the treatment regime followed must take into consideration what is actually causing the varicose vein to present itself in the first instance. By tailoring the surgery to diverting the abnormal blood flow from the area of varicose veins, not only is the cosmetic and symptomatic condition alleviated, but the overall improvement of circulation is achieved also.

CHIVA is widely considered to improve a broad range of conditions by improving circulation (venous function), including:

Alleviate varicose veins, reduce swelling of the legs and avoid ulceration;

Assist in preventing the recurrence and spreading of the symptoms including varicose veins to other parts of the legs; and

CHIVA does not involve stripping of the main trunk of the saphenous vein so it is still available for use in coronary procedures should the patient require them.

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Category: Medicines and Remedies
Keywords: varicose veins, treating varicose veins, surgical treatment of varicose veins