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CHIVA method

Therapy that preserves veins and restores the hemodynamics for insufficient veins on an outpatient basis

As an alternative to stripping varicose veins, the French doctor Claude Franceschi developed the CHIVA method in the 1980s. CHIVA is the abbreviation for the French name of the method (Cure Conservatrice et Hemodynamique de l'Insufficience Veineuse en Ambulatoire) that translates as: Therapy that preserves veins and restores the hemodynamics for insufficient veins on an outpatient basis. The CHIVA method makes use of the fact that the superficial venous system consists of two collecting veins (saphenous veins) and a large number of side branches and communicating veins. When varicose veins form in the venous system, the blood flows in the wrong direction in some places. Affected regions are tied off (ligated) according to a predetermined plan to restore correct blood flow through the remaining veins.

How varicose veins are treated with the CHIVA method

As a rule, varicose veins are treated by the CHIVA method in an outpatient setting and under local anesthetic. First the doctor examines the venous system affected by the varicose veins by ultrasound. Then the physician decides where the veins are to be tied off and marks them on the leg. At these sites, small incisions are made in the skin, through which the varicose veins are then pulled, tied off with a suture and cut. Since most of the incisions are very small, they do not need stitches and are closed with a butterfly bandage. Besides parts of the collecting vein, a few side branches may need to be tied off to prevent blood flowing back into the venous system. Since the venous system is no longer overloaded by blood flowing in the wrong direction, the varicose veins disappear after a while.

After the treatment of varicose veins with the CHIVA method

After the procedure, the patients must wear compression stockings for six weeks. A follow-up examination is necessary after six to eight weeks. At this appointment, further side branches of the venous system may be sclerosed during a supplementary procedure. The CHIVA method is seen as safe and successful, as long as it is practiced by an experienced, trained doctor. Nevertheless, as with all invasive procedures, undesirable effects may occur. These are usually harmless.

They include:
  • allergic reaction to the local anesthetic
  • bruising
  • sensory disorders
Venous insufficiency cannot be treated by varicose vein surgery. Therefore, patients should continue to wear their compression garments every day after successful vein surgery to prevent the onset of new varicose veins and to enjoy the outcome of the operation for years to come.

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