Originally contributed by Dr. Qiang Zhang on the Veinsights . Original Link: here
In the realm of varicose vein treatments, CHIVA (Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire) is emerging as a pioneering, minimally invasive technique that preserves venous function. Despite its growing recognition worldwide, questions remain: Is the fact that CHIVA has not yet become a mainstream treatment a sign of its lack of value? From a professional standpoint, CHIVA has far greater potential than traditional methods, and although it is not yet mainstream, it is poised to become the core treatment choice for varicose veins in the future.
1. Mainstream Doesn’t Always Mean Best
Using the “mainstream” label as a measure of a technique’s value is a logical fallacy. The essence of medical technology lies in its scientific foundation and clinical effectiveness, not its popularity.
The Limitations of Mainstream Treatments: Mainstream treatments are often shaped by historical inertia and economic incentives. For example, traditional vein stripping surgery and laser treatments have been around for years and are widely accepted due to their market maturity. However, this doesn’t mean they are the only or the best solution for varicose veins.
Scientific Evaluation: CHIVA is based on hemodynamic adjustments that focus on preserving functional veins. This approach has shown significant advantages in reducing post-operative complications and improving patients’ quality of life. These benefits have been validated through long-term clinical practice, particularly in Europe.
2. Why CHIVA Is Not Mainstream Today
High Technical Requirements: CHIVA requires a deep understanding of hemodynamics and advanced ultrasound skills from the practitioner. Unlike laser or radiofrequency treatments that rely on technology, CHIVA depends heavily on the physician’s expertise. This high technical threshold has slowed its adoption.
Economic Barriers: Laser and radiofrequency treatments generate substantial revenue due to high consumable costs, making them more appealing to hospitals and physicians from a financial perspective. In contrast, CHIVA has a lower reliance on consumables, which limits its rapid market expansion.
3. CHIVA’s Unique Advantages and Its Future Potential
The Pioneering Vision and Initial Resistance: The CHIVA technique was first proposed by French professor Franceschi, who faced significant skepticism and resistance in the early stages. Many in the medical community criticized the concept as overly complex and contrary to traditional treatment logic. However, through extensive clinical research and long-term scientific validation, Professor Franceschi gradually gained recognition for the scientific foundation of CHIVA, especially within the European vein care community.
Minimally Invasive and Function-Preserving: CHIVA uses precise ligation of specific venous branches to restore blood flow while preserving vein function. This contrasts sharply with the traditional “remove everything” approach of vein stripping surgery.
Better Patient Experience: CHIVA is performed under local anesthesia, usually on an outpatient basis, with a quick recovery time. Unlike traditional treatments, patients do not need to wear compression stockings post-surgery, leading to an overall improvement in their quality of life.
Long-Term Effectiveness: CHIVA focuses on restoring the natural function of the veins, rather than merely eliminating visible varicosities. While some functional veins may remain visible post-treatment, this is not a sign of recurrence, but rather a result of hemodynamic adjustment.
4. Successful Non-Mainstream Technologies: High-Level Skills Often Face Initial Resistance
Throughout medical history, many advanced but initially non-mainstream techniques eventually became standard practices. These success stories prove that scientific rigor and effectiveness ultimately outweigh popularity.
- Minimally Invasive Surgery: In its early stages, techniques like laparoscopic and thoracoscopic surgery were considered too complex and incomplete, failing to compete with open surgeries. However, as the technology matured, these minimally invasive options became the gold standard due to their lower trauma and faster recovery times.
- Da Vinci Surgical Robot: Initially criticized for its high cost and complex operation, robotic surgery now offers unparalleled precision in complex procedures, becoming a crucial tool in fields like urology and gynecology.
- Transcatheter Aortic Valve Implantation (TAVI): Once viewed as a niche technique due to its high technical demands, TAVI has now become a preferred treatment for elderly patients with aortic valve disease due to its broad indications and fast recovery time.
- Coronary Artery Interventions: Early on, coronary interventions were seen as less comprehensive than traditional open-heart surgeries. However, with their minimally invasive nature and high efficiency, these procedures are now widespread.
Like these technologies, CHIVA holds the potential to revolutionize varicose vein treatment. Its scientific foundation and high patient satisfaction will drive its increasing adoption.
5. Global Recognition and Initiatives Supporting CHIVA’s Expansion
International Recognition: CHIVA has already been included in varicose vein treatment guidelines in countries like France and Italy, where it is recommended as a viable treatment option.
Global Projects: Led by Dr. Smile Medical Group in China, in collaboration with the international certification body INTELEOS, global initiatives are working to standardize training, provide technical certifications, and foster academic exchange. These efforts are set to increase CHIVA’s international influence.
Global Training and Certification: Venous associations and medical institutions worldwide are actively offering CHIVA-specific training programs, helping physicians acquire the necessary skills. Certified doctors are now in a better position to implement CHIVA in clinical practice.
International Collaboration: Ongoing academic research and international conferences continue to facilitate knowledge exchange, laying a strong foundation for the global application of CHIVA.
6. A Technology Proven to Benefit Patients and Empower Physicians
Proven Clinical Value: For example, Dr. Smile Medical Group in China has successfully performed over 20,000 CHIVA procedures over the past decade, providing robust clinical data that validates the technique’s scientific basis and high patient satisfaction. This strong evidence base supports CHIVA’s growing acceptance and provides a solid foundation for its wider adoption.
Benefiting Patients: CHIVA is particularly suitable for patients who wish to recover quickly and avoid traditional invasive surgery. These patients not only achieve excellent treatment outcomes but also benefit from the comfort and efficiency of the procedure. The minimally invasive nature, pain-free experience, and function-preserving characteristics significantly enhance post-operative quality of life.
Doctors Leading the Future: As CHIVA continues to gain traction, physicians who choose to learn and master this innovative technique will position themselves at the forefront of the medical field. These doctors will not only provide superior care to their patients but will also gain professional recognition and more opportunities for growth.
7. Overcoming Barriers to CHIVA’s Broader Adoption
To transition CHIVA from a niche treatment to mainstream acceptance, several key actions are necessary:
- Enhanced Training: Establishing an international certification system to train more doctors capable of performing CHIVA procedures.
- Raising Patient Awareness: Educating patients about CHIVA’s advantages to increase their confidence in choosing this innovative approach.
- Long-Term Data Collection: Continuing to collect clinical data that strengthens the evidence for CHIVA’s effectiveness.
Conclusion: The Future Belongs to Science and Patient Needs
The emergence of mainstream technologies is often influenced by a variety of factors, not solely by their inherent superiority. CHIVA’s scientific principles, patient benefits, and long-term effectiveness give it the potential to become a leading treatment for varicose veins in the future. Although it currently faces challenges in broader adoption, as the technology becomes more widespread and patients increasingly demand high-quality healthcare, CHIVA will emerge as an indispensable option in the field of varicose vein treatment.