CHIVA strategy in the treatment of venous insufficiency

Abstract

The approach to the diagnosis and treatment of venous insufficiencies involves two opposing attitudes: demolition and conservation of the venous system. CHIVA is based on knowledge of the pathophysiology of venous insufficiency. Through an accurate and standard echo color Doppler investigation, a mandatory method that must be within the capabilities of a modern phlebologist, the causes of the increase in transmural pressure are identified, a map is prepared and finally a therapeutic strategy aimed at normalizing the transmural pressure is planned. CHIVA represents a scientific progress in the approach to venous insufficiency. The CHIVA strategy is applied mainly, but not only, with conservative surgical tactics based on the faithful reproduction of the strategy planned with the cartography. CHIVA respects venous function and seeks to preserve the GSV useful for all arterial surgery needs. Studies performed according to the rules of evidence-based medicine, Cochrane reviews and meta-analyses certify the validity of the CHIVA strategy in the treatment of venous insufficiencies of the lower extremities.