Comparative Efficacy and Safety of CHIVA vs. HLS in the Treatment of Varicose Veins: A Meta-Analysis

A meta-analysis published in Medicine (Baltimore), November 2023, evaluates the efficacy and safety of the Conservative Hemodynamic Cure for Venous Insufficiency (CHIVA) compared to High Ligation and Stripping (HLS) for treating varicose veins of the lower extremities. This study provides a systematic review of randomized controlled trials and retrospective cohort studies to determine the optimal treatment approach.

Study Overview

The analysis included data from 14 research articles, utilizing comprehensive databases and meta-analysis software tools such as Revman 5.3 and Stata 13.0. The objective was to compare CHIVA, a less invasive, ultrasound-guided method, with the traditional HLS technique, focusing on various clinical outcomes.


  • Operation Time and Blood Loss: CHIVA was associated with a shorter operation time and less blood loss compared to HLS, indicating a more efficient procedure.
  • Surgical Incisions and Hospital Stay: Patients treated with CHIVA had fewer surgical incisions and shorter hospital stays, suggesting a less invasive nature and quicker recovery.
  • Relapse Rates: The relapse rate for varicose veins was significantly lower in patients undergoing CHIVA, pointing to its superior long-term efficacy.
  • Complications: CHIVA showed a lower overall complication rate, including reduced incidences of deep vein thrombosis, sensory disturbances, nerve injuries, and hematomas.


The meta-analysis concludes that CHIVA offers significant advantages over HLS in treating varicose veins of the lower extremities. With benefits such as reduced operation time, less blood loss, fewer surgical incisions, shorter hospital stays, lower relapse rates, and fewer complications, CHIVA emerges as a preferable treatment option. These findings highlight the importance of considering less invasive, hemodynamically focused approaches in the management of varicose veins.

This comprehensive comparison underscores the need for a paradigm shift in the treatment of varicose veins, favoring methods that not only address the immediate symptoms but also contribute to better long-term outcomes and patient quality of life.

For more detailed information, access the original article on PubMed: Comparison of the efficacy and safety of ultrasound-guided CHIVA and traditional HLS in the treatment of varicose veins of lower extremities – a meta-analysis.

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