Diameter reduction of the great saphenous vein and the common femoral vein after CHIVA

Summary

Introduction: The diameters of great saphenous vein (GSV) and common femoral vein (CFV) seem to give a hint about the severity of venous illness. A reduction of these diameters 8 weeks after CHIVA of GSV was demonstrated earlier (3), the longterm effect has not been published so far. As the GSV persists in situ and drains the leg blood through distal perforators into the deep vein, an overload oft he CFV after CHIVA has been postulated. The aim of this study is to discover long time effects of CHIVA on diameters of CFV.

Methods: 43 Patients included in the first trial was explored 5 years after CHIVA of GSV or SSV. Diameters were measured in standing position: CFV diameter immediately after the confluence with the GSV and GSV diameter 15 cm distally to the groin. Clinic class (CEAP) and refilling time were compared to preoperative values and values after 8 weeks.

Results: 43 patients (mean age 52.7 years) were explored 5.36 years after CHIVA operation of their saphenous veins. Diameter of CFV was reduced from preoperative 15.39 ± 2.93 mm (15.11 ± 2.73 after 8 weeks) to 14.18 ± 2.56 mm (p<0.05). In case of treatment of GSV the diameter of CFV changed from preoperative 16.07 ± 2.65mm through 15.29 ±0.41 mm after 8 weeks to 14.30 ± 2.81 mm (p<0.001). The diameter of GSV was reduced from 7.13 ± 2.05 mm pre-operative (4.98 ± 1.49 mm after 8 weeks) to 4.38 ± 1.44 mm after 5 years (p<0.001). The C class was reduced from 2.77 ± 0.81 preoperatively to 1.72 ± 1.10 after 5 years (p = 0.007). Refilling time was prolonged from preoperatively 15.24 ± 6.18s to 21.61 ± 9.2s after 5 years (p = 0.022).

Conclusion: As already shown in the short term results, CHIVA reduced the caliber of the CFV and GSV as well as the C Class of CEAP and improved the refilling time. These results were also stable after 5 years.

English version available at: www.phlebologieonline.de

Keywords

Varicose veins - CHIVA - vein diameter - long term results

• Literatur

• 1 Coleridge-Smith P. et al. Duplex Ultrasound Investigation of the Veins in Chronic Venous Disease of the Lower Limbs—UIP Consensus Document. Part I.. Basic Principles European Journal of Vascular and Endovascular Surgery 2006; 31 (01) 83-92.
• 2 Mendoza E, Blättler W, Amsler F. Great Saphenous Vein Diameter at the Saphenofemoral Junction and Proximal Thigh as Parameters of Venous Disease Class.. European Journal of Vascular and Endovascular Surgery 2012; 45 (01) 76-83.
• 3 Mendoza E. et al. Kaliberreduktion der V. saphena magna und der V. femoralis communis nach CHIVA.. Phlebologie 2011; 40 (02) 73-78.
• 4 Parés JO. et al. Varicose Vein Surgery: Stripping vs. the CHIVA method. A Randomized Controlled Trial.. Ann Surg 2010; 251: 624-631.
• 5 Carandina S. et al. Varicose Vein Stripping vs Haemodynamic Correction (CHIVA): a Long Term Randomised Trial.. Eur J Vasc Endovasc Surg 2008; 35 (02) 230-237.
• 6 Kostecki J. et al. Haemodynamic changes of the deep vein system of the leg after surgery of the incompetent great saphenous vein.. Phlebologie 2010; 39: 18-23.