Conservative Hemodynamic Treatments: The Future of Varicose Vein Management — Insights from C Franceschi’s Research


Varicose veins, a prevalent vascular disorder resulting from venous insufficiency, pose significant challenges in vascular medicine. Traditional treatments have often focused on ablative and destructive methods, which, while effective in symptom management, do not address the underlying hemodynamic imbalances and deprive the patient of vein graft for future arterial bypass needs. The evolution of conservative hemodynamic treatments marks a significant shift towards addressing these foundational issues, offering a path to more sustainable and patient-friendly management strategies.

Understanding Hemodynamic Principles

At the heart of conservative treatments lies a deep understanding of venous hemodynamics. Historical and contemporary research underscores the importance of preserving the Great Saphenous Vein (GSV) not just for immediate symptom relief but for long-term vascular venous health and to provide an invaluable graft in cases of arterial disease. The work of C Franceschi, detailed in his seminal paper “Venous Hemodynamics for GSV sparing Graft and Improved Varicose Treatment Focus on Saphenous Sparing Grafts,” published in the Vasculab Journal of Theoretical and Applied Vascular Research, Volume 8, Issue 2, 2023, provides compelling evidence for this approach. Franceschi’s research emphasizes the significance of managing the transmural pressure (TMP) within the venous system to alleviate symptoms and prevent further complications.

The CHIVA Strategy

Introduced by Franceschi, the CHIVA (Conservative and Hemodynamic Treatment of Varicose Veins in Ambulatory Patients) strategy represents a paradigm shift in varicose vein management. By strategically preserving the GSV and addressing the hemodynamic causes of venous insufficiency, CHIVA offers a method that not only treats varicose veins but also contributes to the overall health of the venous system and spares vein grafts for possible vital arterial bypasses. This approach has been shown to have superior long-term efficacy in treating varicose veins, with the added benefit of preserving the GSV for potential future medical needs.

Comparative Analysis

The advantages of conservative hemodynamic treatments over traditional ablative methods are becoming increasingly clear. A comparative analysis highlights the superior long-term outcomes, the preservation of the GSV, and the focus on treating the underlying cause of venous insufficiency rather than just its symptoms.


The future of varicose vein management is being reshaped by the insights and research of C Franceschi and others in the field. Conservative hemodynamic treatments, exemplified by the CHIVA strategy, offer a more sustainable, effective, and patient-friendly approach to managing this common vascular disorder. As research continues to evolve, these methods are expected to become a cornerstone of varicose vein treatment protocols, offering new hope and improved outcomes for patients worldwide.


Franceschi, C. (2023). Venous Hemodynamics for GSV sparing graft and improved varicose treatment. Focus on Saphenous Sparing Grafts. Vasculab Journal of Theoretical and Applied Vascular Research, 8(2). Original Article Link

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