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Varicose Vein Surgery: Stripping Versus the CHIVA Method: A Randomized Controlled Trial.

Annals of Surgery, 2010


OBJECTIVE:: The objective of this randomized study was to compare the efficacy of the CHIVA method for the treatment of varicose veins with respect to the standard treatment of stripping.
For over a century, varicose veins have been treated with surgical ablative techniques, with stripping being the standard treatment.
Currently, postsurgical varicose veins recurrence (20%-80%) is a common, complex, and costly problem.
Ambulatory Conservative Hemodynamic Management of Varicose Veins (CHIVA) is a new option for treating chronic venous disorder.
METHODS:: In this open-label, randomized controlled trial, 501 adult patients with primary varicose veins were treated in a single center.
They were assigned to an experimental group, the CHIVA method (n = 167) and 2 control groups: stripping with clinic marking (n = 167) and stripping with duplex marking (n = 167).
The outcome measure was clinical recurrence within 5 years, assessed clinically by previously trained independent observers.
RESULTS:: In an intention-to-treat analysis, clinical outcomes in the CHIVA group were better (44.3% cure, 24.6% improvement, 31.1% failure) than in both the stripping with clinic marking (21.0% cure, 26.3% improvement, 52.7% failure) and stripping with duplex marking (29.3% cure, 22.8% improvement, 47.9% failure) groups.
The ordinal odds ratio between the stripping with clinic marking and CHIVA groups, of recurrence at 5 years of follow-up, was 2.64, (95% confidence interval [CI]: 1.76-3.97, P < 0.001).
The ordinal odds ratio of recurrence at 5-years of follow-up, between the stripping with duplex marking and CHIVA group, was 2.01 (95% CI: 1.34-3.00, P < 0.001).