CHIVA:The Short-term Effect Of Treating Varicose Veins Of Lower Extremities Based On The Principle Of Hemodynamics

Objective(s):To discuss the clinical effects and postoperative complications of CHIVA surgery for varicose veins of the lower extremities.Methods:The clinical data of 39 affected limbs of 37 patients with varicose veins of lower extremities treated in the Department of Vascular surgery of the 920th Hospital of the Joint Logistics support Force of the Chinese people’s Liberation Army from August 2019 to January 2021 were collected and analyzed.Follow-ups were conducted at 1 and 3 months after surgery.The contents of follow-up included:improvement of postoperative clinical symptoms,postoperative satisfaction,improvement of postoperative appearance,postoperative complications(postoperative pain,deep venous thrombosis,nerve injury,superficial thrombophlebitis,operative mouth infection,etc.),hemodynamic parameters before and 3 days after surgery,etc.were analyzed for curative effect.Results:1.Improvement of clinical symptoms:According to the VCSS score,the clinical severity of veins was statistically different before and after surgery(P<0.05).According to the patient’s subjective wishes,15 limbs(38.5%)without any clinical symptoms after operation,15 limbs(38.5%)with occasional slight discomfort,7 limbs(17.9%)with improved symptoms and 2 limbs(5.1%)with the same clinical symptoms as before operation.2.Overall satisfaction:9 cases were very satisfied(24.3%),11 cases were quite satisfied(29.7%),14 cases were satisfied(37.8%),and 3 cases were dissatisfied(8.1%).3.Appearance improvement:13 limbs(33.3%)were completely improved,15 limbs(38.5%)were significantly improved,9 limbs(23.1%)were slightly improved,and 2 limbs(5.1%)had no significant changes before and after surgery,According to the statistical analysis of C2 and C4-C6 patients,there were 18 affected limbs in C2 grade,of which 8 limbs varicose veins disappeared completely,and the effective rate was 44.4%.The total number of varicose veins in C4-C6 grade was 21,only 5 limbs varicose veins disappeared completely,and the effective rate was 23.8%.4.Postoperative complications:postoperative pain in 9 limbs(23.1%),lower limb deep venous thrombosis in 0 limb,nerve injury in 1 limb(2.6%),superficial thrombophlebitis in 1 limb(2.6%)and incision infection in 1 limb(2.6%).5.Hemodynamic parameters before and 3 days after operation:statistical analysis of the diameter and reflux time of the saphenous vein before and 3 days after operation showed statistical differences(P<0.05).Conclusion(s):CHIVA has the advantages of local anesthesia,minimally invasive,less pain,fast recovery,less nerve injury and free movement after operation,but CHIVA surgery requires individualized treatment and accurate evaluation of hemodynamics by vascular Doppler ultrasound,otherwise it is easy to make mistakes in strategy formulation and affect the effect of the operation.