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Randomized Controlled Trial
. 2008 Feb;35(2):230-7.
doi: 10.1016/j.ejvs.2007.09.011. Epub 2007 Oct 26.

Varicose Vein Stripping vs Haemodynamic Correction (CHIVA): A Long Term Randomised Trial

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Randomized Controlled Trial

Varicose Vein Stripping vs Haemodynamic Correction (CHIVA): A Long Term Randomised Trial

S Carandina et al. Eur J Vasc Endovasc Surg. .
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Abstract

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.

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