Ultrasound-guided mini-incision technique for CHIVA.

CHIVA (Cure Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire) is a surgical technique for varicose veins that avoids destroying the saphenous vein and collaterals. In some patients, the flush ligation of saphenous collaterals performed in the CHIVA technique may require more dissection than is desirable. This is especially valid for obese patients and thigh ligations. We report an innovative technique that uses duplex-guided puncture to bring the collateral closer to the skin and reduce the need for dissection and incision. The technique does not change any of the CHIVA principles. While the long-term results are not yet known, we expect them to be similar to normal CHIVA procedures.