The presence of haemodynamic abnormalities in chronic venous disease (CVD) has been well established. The relationships between these abnormalities and clinical manifestations, or natural history of CVD, are complex and remain to be investigated. Flow-mediated processes and mechanisms unrelated to blood flow may play an important role in the pathophysiology of CVD. Current state of knowledge makes questionable a possibility of building treatment strategies based on a single simplified model of the disease. As an example of such simplified approach, CHIVA introduces an opportunity to critically assess the gaps in knowledge in venous pathophysiology.
FranceschiC. Theory and Practice of the Conservative Haemodynamic Treatment of Incompetent and Varicose Veins in Ambulatory Patients. France: Precy-sous-Thil & Eacuteditions de l'Armancon, 1993
2.
PollackAA, WoodEH. Venous pressure in the saphenous vein at the ankle in man during exercise and changes in posture. J Appl Physiol1949;1:649–62
3.
AlimiYS, BarthelemyP, JuhanC. Venous pump of the calf: a study of venous and muscular pressures. J Vasc Surg1994;20:728–35
4.
HojensgardIC, SturupH. Static and dynamic pressures in superficial and deep veins of the lower extremity in man. Acta Physiol Scand1952;27:49–67
LurieF, OgawaT, KistnerRL, EklofB. Changes in venous lumen size and shape do not affect the accuracy of volume flow measurements in healthy volunteers and patients with primary chronic venous insufficiency. J Vasc Surg2002;35:522–6
7.
AlmenT, NylanderG. Serial phlebography of the normal lower leg during muscular contraction and relaxation. Acta Radiol1962;57:264–72
8.
ArnoldiCC. On the conditions for the venous return from the lower leg in healthy subjects and in patients with chronic venous insufficiency. Angiology1966;17:153–71
9.
LaughlinMH, SchrageWG. Effects of muscle contraction on skeletal muscle blood flow: when is there a muscle pump?Med Sci Sports Exerc1999;31:1027–35
10.
NaamaniR, HussainSN, MagderS. The mechanical effects of contractions on blood flow to the muscle. Eur J Appl Physiol Occup Physiol1995;71:102–12
11.
BjordalRI. Circulation patterns in incompetent perforating veins in the calf and in the saphenous system in primary varicose veins. Acta Chir Scand1972;138:251–61
12.
NeglenP, RajuS. Differences in pressures of the popliteal, long saphenous, and dorsal foot veins. J Vasc Surg2000;32:894–901
LabropoulosN, GiannoukasAD, DelisK, Where does venous reflux start?J Vasc Surg1997;26:736–42
15.
LabropoulosN, LeonL, KwonS, Study of the venous reflux progression. J Vasc Surg2005;41:291–5
16.
MakarovaNP, LurieF, HmelnikerSM. Does surgical correction of the superficial femoral vein valve change the course of varicose disease?J Vasc Surg2001;33:361–8
17.
SarinS, ShieldsDA, FarrahJ, ScurrJH, Coleridge-SmithPD. Does venous function deteriorate in patients waiting for varicose vein surgery?J R Soc Med1993;86:21–3
18.
DwerryhouseS, DaviesB, HarradineK, EarnshawJJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg1999;29:589–92
19.
PerrinMR, GuexJJ, RuckleyCV, Recurrent varices after surgery (REVAS), a consensus document. REVAS group. Cardiovasc Surg2000;8:233–45
20.
KostasT, IoannouCV, TouloupakisE, Recurrent varicose veins after surgery: a new appraisal of a common and complex problem in vascular surgery. Eur J Vasc Endovasc Surg2004;27:275–82
21.
BerganJJ. Regarding neovascularization: an innocent bystander in recurrent varicose veins. J Vasc Surg2007;46:177–8
22.
JonesL, BraithwaiteBD, SelwynD, CookeS, EarnshawJJ. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg1996;12:442–5
23.
LabropoulosN, BhattiA, LeonL, BorgeM, RodriguezH, KalmanP. Neovascularization after great saphenous vein ablation. Eur J Vasc Endovasc Surg2006;31:219–22
24.
van RijAM, JonesGT, HillGB, JiangP. Neovascularization and recurrent varicose veins: more histologic and ultrasound evidence. J Vasc Surg2004;40:296–302
25.
RicciS. Letter to Editor re: Varicose Vein Stripping vs. Haemodynamic Correction (CHIVA): a Long Term Randomised Trial. Eur J Vasc Endovasc Surg2008;36:118–9
26.
CarandinaS, MariC, DePM, Varicose vein stripping vs. haemodynamic correction (CHIVA): a long term randomised trial. Eur J Vasc Endovasc Surg2008;35:230–7
27.
ZamboniP. La correzione emodinamica dell'IVC con strategia conservativa – CHIVA. In: AgusGB, ed. Chirurgia delle varici. Italy: EDRA Milano Publisher; 2006:281
