#1 - Varicose veins: Trailer indroducing the hemodynamic saphenous vein sparing surgery , CHIVA method.

This video introduce the concept that the saphenous vein must not be stripped or burned with the Laser. CHIVA treatment preserve the saphenous vein and let the patient the possibility to use it for a coronary by pass , if it will be necessary.

#2 - Cosmetic outcomes in 10 varicose veins clinical cases treated with CHIVA method.

The videoclip shows the progressive cosmetic result and demonstrate that avoiding or limiting phlebectomy and sclerotherapy a cosmetic result better than other methods can be reached.

#3 - CHIVA treatment. From venous cartography to the stitches removal.

CHIVA treatment is a mini-invasive surgery, easy to perform for surgeons and for the patients. Local anesthesia allows an exellent analgesia during and after surgery and allows the patient to walk immediately and to return his home. The day after surgery the patient can attend his normal activity, except a shower.

#4 - CHIVA & cosmetic outcomes: Telangectasia

This patient had undergone sclerotherapy for below knee telangectasia. Some months later, recurrence occurred with matting complication Duplex scan investigation elicited a Shunt II made of a competent sapheno-femoral junction and an incompetent Anterior Saphena whose retrograde flow overloaded an incompetent tributary responsible for the telangecatasia. CHIVA treatment, that consisted of SHUNT II disconnection through two mini-incisions, led to outstanding aesthetic outcomes without any additional sclerotherapy

#5 - Perthes test : expectation of CHIVA cosmetic outcomes

This clip shows how phlebectomy can be limited or completely avoided. This choise , that is integrated in CHIVA strategy, allows to improve the final cosmetic outcomes in complex and extended varicose veins.

#6 - Clinical effectivness of hemodynamic venous sparing surgery in a very advanced stage of cronic venous insufficiency

CHIVA strategy allows to resolve this advanced cronic venous insufficiency stage with a very simple surgery. Only a sapheno phemoral junction flush ligation and and the interruption of the saphenous trunk below the re-entry perforator is sufficient, as you can see in videoclip, to improve this advanced lipodermatosclerosis.

#7 - Role of the great saphenous trunk where deep veins are obstructed

This clip describes the vicarious function of the great saphenous trunk where deep veins are obstructed. This function is due to a pressure gradient that during calf contraction exists between the muscle pump and the right heart, and is no due to the valves function. This means that also an incompetent saphenous trunk can drive the flow towards the heart. Removing or ablating it , means to deprive the patient of a possibility to improve his health.

#8 - Consequence of a Hunter perforator recurrence.

Varicose veins are a chronic disease. The presence of a draining saphenous axis, whatever its flow  direction : Allows a good drainage of superficial tissues, so preventing  the appearance of telangiectasias or blue reticular veins refractory to sclerotherapy Confines  the reflux fed by  new or left behind escape points as  SFJ , Hunter perforator, pelvic escape points, in an appropriate vein  , instead of in anarchic neo-varicose veins . Lets of avoiding  re-do surgery when  the shunt overload is innocent in terms of symptoms and signs as drainage impairment and visible varicose vein as shown in the reported case. .  While an easy   re-do mini-surgery is  feasible if this recurrence is responsible for recurrent symptoms and or signs. Conclusion : the preservation of the  saphenous trunk  eases the management of the recurrence or evolution of this chronic disease and make our patients satisfied.