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Khirurgii

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Year 2020 Vol. 28 No 6

REVIEWS

V.I. GOLOVINA, E.I. SELIVERSTOV, O.I. EFREMOVA, I.A. ZOLOTUKHIN

POSSIBILITIES AND PROSPECTS OF HEMODYNAMIC SURGERY OF VARICOSE VEINS IN THE ERA OF ENDOVASCULAR THERMAL OBLITERATION

N.I. Pirogov Russian National Research Medical University, Moscow,
Russian Federation

For a long time, the complete removal of the saphenous vein trunk has been considered to be the only effective surgical treatment of varicose veins. Over time, in addition to modifications to the removal of veins with the help of probes, endovenous thermal methods of obliteration also appeared, however, complete excision / obliteration of the incompetent segment of the trunk still remained common in all these techniques. This concept began to undergo changes only after the appearance and the development of duplex ultrasound scanning of blood vessels, which made it possible to investigate deeply the venous system hemodynamics and, as a result, to determine the further necessary treatment technique for each patient individually. Due to a detailed study of the venous hemodynamics, in 1988 French angiologist Claude Franceschi proposed the method of the ambulatory conservative hemodynamic correction of venous insufficiency (Conservatrice et Hémodynamique de l’InsuffisanceVeineuse en Ambulatoire), which became known in the world as the CHIVA. This method implies the elimination of the hydrostatic pressure column in the vein, removal of blood recirculation mechanism, maintaince re-entry mechanism and elimination of tributaries which are not connected with re-entry point. As a result of CHIVA performance the normal physiological blood flow is restored by eliminating reflux from the deep vein to the superficial vein and maintaining drainage from superficial to the deep veins. In the presented review, the advantages and disadvantages of the CHIVA method are examined in details, as well as a comparative analysis of the technique with other currently existing methods of treatment of varicose vein disease.

Keywords: varicose veins, phlebectomy, vein saving surgery, hemodynamic correction, CHIVA
p. 702-713 of the original issue
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Address for correspondence:
117997, Russian Federation,
Moscow, Ostrovityanov str., 1,
N.I. Pirogov Russian National
Research Medical University,
the Faculty Surgery Department No1.
tel. +7 977 605-17-08,
e-mail: nikuskin@inbox.ru,
Golovina Veronika I.
Information about the authors:
Golovina Veronika I., Post-Graduate Student, the Faculty Surgery Department No1, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-8719-7154
Seliverstov Evgeny I., PhD, Assistant of the Faculty Surgery Department No1, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-9726-4250
Efremova Oksana I., PhD, Assistant of the Faculty Surgery Department No1, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0001-5906-8120
Zolotukhin Igor A., MD, Professor of the Faculty Surgery Department No1, Head of the Department of Basic and Applied Research in Surgery of RI of Clinical Surgery, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-6563-0471
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