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CHIVA method is a type of surgery used to treat varicose veins that occur as a result of long term venous insufficiency. [1] The term is a French acronym for Conservatrice Hémodynamique de l'Insuffisance Veineuse en Ambulatoire (ambulatory conservative hemodynamic treatment venous insufficiency).
The distal veins are removed following the complete ablation of the proximal vein. This treatment is most commonly used for varicose veins off of the great saphenous vein, small saphenous vein, and pudendal veins. [60] Follow-up treatment to smaller branch varicose veins is often needed in the weeks or months after the initial procedure.
Medicare may cover varicose vein treatment if it is deemed medically necessary. Learn more here.
Sclerotherapy has been used in the treatment of spider veins and occasionally varicose veins for over 150 years. Like varicose vein surgery, sclerotherapy techniques have evolved during that time. Modern techniques including ultrasonographic guidance and foam sclerotherapy are the latest developments in this evolution.
The vein can be identified near the saphenous ostium by a typical ultrasonographic image the so-called Mickey mouse sign (the 2 ears will be the GSV and the ASV, the head is the common femoral vein). When the ultrasonography is performed, we can see it running across the anterior face of the thigh in a plan outside the femoral vessels, the GSV ...
Polidocanol causes fibrosis inside varicose veins, occluding the lumen of the vessel, and reducing the appearance of the varicosity. The FDA has approved polidocanol injections for the treatment of small varicose (less than 1 mm in diameter) and reticular veins (1 to 3 mm in diameter).