Saphenous Sparing Strategy in the CHIVA Context

Since its publication in 1988 by Claude Franceschi, lots of professionals of phlebology have understood the challenge and learned about venous networks, reflux and drainage pathways, shunt types and venous function restoration. Depending on the shunt type, different treatment decisions are possible and necessary. This chapter aims to explain the single steps to decide which treatment to apply to which patient with superficial venous reflux. It starts explaining the definitions used in the international CHIVA group. Then the treatment options in case of each possible compartment jump are explained. Finally, the treatment strategy depending on the shunt type is summarised and illustrated with clinical examples. An essential basis to understand and take profit from this chapter is the comprehension of shunt types as described in Sects. 3.7–3.9, based on the knowledge acquired in Chap. 2 (functional anatomy), Chap. 3 (physiology) and Chap. 4 (duplex ultrasound investigation).