The office based CHIVA

Fausto Passariello,¹ Stefano Ermini,² Massimo Cappelli,³ Roberto Delfrate,⁴ Claude Franceschi<sup>5

1</sup>Centro Diagnostico Aquarius, Napoli, Italy; ²Private Practice, Grassina, Italy; ³Private Practice, Firenze, Italy; ⁴Casa di Cure Figlie di Maria, Cremona, Italy; ⁵Hospital St Joseph, Service d'Explorations Vasculaires, Paris, France

Abstract: The cure Conservatrice Hémodynamique de l'Insuffisance Veineuse en Ambulatoire (CHIVA) can be office based (OB). The OB-CHIVA protocol is aimed at transferring CHIVA procedures to specialists rooms. The protocol will check the feasibility of OB-CHIVA, data pertaining to recurrence, and will offer the opportunity to study saphenous femoral junction (SFJ) stump evolution, the role of the washing vessels and the arch recanalization rate, and gather new data about the effect of the length of the treated saphenous vein. A simplified diagnostic procedure will allow an essential ultrasound examination of the venous net while a schematic and easily readable algorithm guides therapeutic choices. The Riobamba draining crossotomy (RDC) tactic is composed of a set of OB procedures. While some of these procedures are, at the moment, only proposals, others are already applied. Devices generally used in ablative procedures such as Light Amplification by Stimulated Emission of Radiation (LASER), radio frequency, steam, and mechanical devices are used in this context to serve to conservative interventions for CHIVA. New techniques have also been proposed for devalvulation and tributary disconnection. Detailed follow-up is necessary in order to determine the effects of therapy and possible disease evolution. Finally, information is added about the informed consent and the ethical considerations of OB-CHIVA research.

Keywords: CHIVA, office based procedures, LASER, RF, steam