CHIVA: Surgical Tips and Tricks

In the CHIVA context, the most important step is the analysis of the preoperative haemodynamics, followed by the decision which strategic, surgical steps to apply. These surgical steps have to be performed in a cautious way, to avoid lesion of vessels that should stay intact. This differentiates the surgical gesture in CHIVA from the ablative strategies. Technical errors are immediately noted with persistent or recurrent varicose veins. In this chapter, the performance of the crossotomy is explained, as well as the interruption of a CHIVA 2 point. Devalvulation is explained, as well as the application to endoluminal techniques to the CHIVA strategy.