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A Journal on Phlebology
Acta Phlebologica 2007 April;8(1):21-9
C.H.I.V.A.: principles and technique evolutions
De Palma M., Carandina S., Fogato L., Legnaro A., Fortini P., Gianesini S., Zamboni P.
Department of Surgical, Anaesthesiological and Radiological Sciencies Vascular Disease Center University of Ferrara, Italy
The CHIVA (Haemodynamic Correction of the Venous Insufficiency on ambulatory setting) was described in 1986 by Dr. Claude Franceschi. Venous haemodynamic is the practical support on which is applied the C.H.I.V.A. treatment, by using the principles of the veno-venous shunts disconnection; of the hydrostatic column fractioning and the respect of the re-entry perforators, in order to re-estabilish the hierarchical order of the blood emptying in the veins of the lower limb characterized by the blood flow from the superficial system to the saphenous system and from this last one to the deep system. The main step to achive it is the preoperative haemodynamic cartography, in witch were drown all the compartment-changes, through escape points, and all the re-entry points into the deep venous system. On the base of the haemodynamic map, a minimally invasive surgery can be executed in a Day Surgery setting, in local anesthesia , to correct the circulation of the superficial venous system taking advantage of the patient anatomical defense system.