In a landmark development, CHIVA (Conservative Hemodynamic Cure for Venous Insufficiency) treatment has been officially recognized in the latest clinical guidelines issued by three major U.S. medical societies: the Society for Vascular Surgery (SVS), the American Venous Forum (AVF), and the American Vein and Lymphatic Society (AVLS). This inclusion signals a pivotal moment for vein care in the United States, as CHIVA offers a minimally invasive, vein-preserving alternative for managing varicose veins.
Bringing CHIVA to the U.S.: Dr. Smile Medical Group and Inteleos Lead the Charge
The introduction of CHIVA to the U.S. market is driven byDr. Smile Medical Group, a global leader in vein care, and Inteleos, a key player in medical certification and education. Together, they have laid the groundwork for bringing CHIVA into the spotlight of U.S. healthcare. Up until now, no specialized CHIVA treatment centers exist in the U.S., but plans are already underway to establish the first CHIVA training center in New York, a move that could revolutionize how varicose veins are treated nationwide.
Clinical Evidence Backs CHIVA’s Effectiveness
Although clinical guidelines recommend the use of CHIVA for early-stage varicose veins and specifically emphasize that CHIVA must be performed by experienced, well-trained professionals, a multi-center study by Dr. Smile Medical Groupy shows that CHIVA offers clear advantages for patients across all stages of varicose vein disease, from mild cases (C2) to more severe conditions , including venous ulcers（C6）. The research highlights CHIVA’s ability to not only reduce recurrence rates but also significantly improve patient outcomes by preserving the function of the great saphenous vein. This is a major departure from traditional vein-stripping or ablation techniques, which remove or destroy the vein entirely and can lead to higher rates of recurrence and complications.
One of the reasons for CHIVA’s lower recommendation level (Grade 2, weak recommendation) and moderate strength of evidence (Grade B) is related to the steep learning curve and the negative impact caused by suboptimal CHIVA procedures.
CHIVA, as a vein-preserving, minimally invasive treatment, requires physicians to have a deep understanding of venous hemodynamics and advanced technical skills. The complexity lies in the fact that physicians not only need to grasp the principles of hemodynamics but also execute the procedure skillfully to correct venous reflux without damaging the veins. Due to the high level of technical difficulty involved, physicians often need to go through a prolonged learning curve to achieve optimal results. During this period, if the procedure is not performed correctly, it can lead to suboptimal outcomes or even treatment failure. This challenging learning curve is one of the key factors affecting CHIVA’s recommendation level.
As CHIVA technology has been promoted globally, some physicians who have not undergone comprehensive training or lack experience have failed to achieve the expected outcomes when performing the procedure, resulting in negative outcomes. These suboptimal CHIVA procedures can lead to disease recurrence or postoperative complications. Such negative reports have tarnished CHIVA’s overall reputation and made guideline developers more cautious about the technology, further affecting its recommendation level and strength of evidence.
A Vein Treatment Breakthrough for U.S. Patients
With CHIVA now included in these leading clinical guidelines, U.S. physicians have a new, patient-friendly option for treating varicose veins. CHIVA’s focus on vein preservation aligns perfectly with the growing demand for minimally invasive procedures that offer faster recovery times and better long-term results. As the first CHIVA training center in New York prepares to open its doors, more U.S. doctors will be trained in this advanced technique, ensuring wider access for patients nationwide.
Global Impact and Future Expansion
The inclusion of CHIVA in these guidelines represents a critical step in the treatment’s global expansion. As one of the few treatments that offer a non-destructive approach to varicose vein care, CHIVA is poised to gain traction not only in the U.S. but also in other major medical markets. Dr. Smile Medical Group’s initiative to bring CHIVA to the U.S. is part of a broader strategy to establish vein treatment centers around the world, making it easier for patients everywhere to access this innovative therapy.
As more clinics adopt the CHIVA technique and the global CHIVA training network—especially in the U.S.—continues to expand, this treatment is expected to become the preferred option for patients and physicians seeking vein-preserving, natural recovery therapies in the coming years.