Varicose vein stripping vs haemodynamic correction (CHIVA): a long term randomised trial

Eur J Vasc Endovasc Surg. 2008 Feb;35(2):230-7. doi: 10.1016/j.ejvs.2007.09.011. Epub 2007 Oct 26.


Objectives: To compare the long-term results of stripping vs. haemodynamic correction (Ambulatory Conservative Haemodynamic Management of Varicose Veins, CHIVA) in the treatment of superficial venous incompetence resulting in chronic venous disease (CVD).

Design: Randomised comparative trial.

Patients: 150 patients affected by CVD, CEAP clinical class 2-6, were randomised to saphenous stripping or to CHIVA.

Methods: The clinical outcome was assessed by an independent observer who recorded the Hobbs clinical score for treated limbs. A subjective report of the outcome was provided by the patients. Recurrence of varices was assessed by both clinical examination and duplex ultrasonography.

Results: The mean follow-up was 10 years, 26 patients were lost to follow-up. The Hobbs score similar in the stripping and CHIVA groups. However recurrence of varicose veins was significantly higher in the stripping group (CHIVA 18%; stripping 35%, P<0.04 Fisher's exact test), without significant differences in the rate of recurrences from the sapheno-femoral junction. The associated risk of recurrence at ten years was doubled in the stripping group (OR 2.2, 95% CI 1-5, P=0.04).

Conclusions: Recurrent varices occurred more frequently following saphenous stripping than after CHIVA treatment. The deliberate preservation of the saphenous trunk as a route of venous drainage in the CHIVA group may have been a factor reducing the recurrence rate.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Chronic Disease
  • Female
  • Hemodynamics*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Satisfaction
  • Risk Assessment
  • Secondary Prevention
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / etiology
  • Varicose Veins / physiopathology
  • Varicose Veins / surgery*
  • Vascular Surgical Procedures*
  • Venous Insufficiency / complications*
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / physiopathology
  • Venous Insufficiency / surgery