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12.24 bellmunt presentación bellmunt_english
1. S E R G I B E L L M U N T , J M E S C R I B A N O ,
V F E R N Á N D E Z - V A L E N Z U E L A , O . L A P I E D R A
A N G I O L O G Í A Y C I R U G Í A V A S C U L A R
I N S T I T U T Q U I R Ó N - D E X E U S
B A R C E L O N A
¿Podemos combinar estrategias
hemodinámicas con técnicas ablativas?
Can we combine hemodynamic and
ablation techniques?
4. - Disconnection
of the scape point
- Fragmentation
of the venous
pressure column
-Preservation
of the re-entry
perforators
-Disconnetion
of venous-venous
shunts
-Abolition
of undrained
superficial
varicose veins
J Juan, JM, Escribano, E Criado, J Fontcuberta.
Haemodynamic surgery for varicose veins: surgical strategy Phlebology 2005; 20: 2–13
5. ¿Why CHIVA?
Bellmunt-Montoya S, Escribano JM, Dilme J, Martinez-Zapata MJ.
CHIVA method for the treatment of chronic venous insufficiency. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD009648
15. Techniques
Técnica Invasivity Efficacy* Control
Open surgery XXX XXX XXX
Sclerotherapy X XXX X
Endovenous
ablation
XX XXX XXX
*Nesbitt C, Bedenis R, Bhattacharya V, Stansby G. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy
versus open surgery for great saphenous vein varices. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.:
CD005624. DOI: 10.1002/14651858.CD005624.pub3.
16. Objective
Evaluate the results of implementing the
CHIVA-method using radiofrequency for
closing the SFJ scape point
18. Technique
Radiofrequency (Vnous Closure®)
Access:
Ultrasound guided puncture of the saphenous vein
Using the varicose vein origin from the saphenous vein
Length of treatment of the saphenous vein:
2 cms from terminal valve
7-14 cm
Completion of a CHIVA method:
Disconnection of shunts
Abolition of undrained superficial varicose veins (phlebectomy
or sclerotherapy)
Preservation of re-entry perforators
19. Results
August 2012 – March 2015
n= 34 patients/37 legs
26 women/ 8 men
Follow-up: 12 months (1-38 m.)
20. Results
Veins affected:
35 great saphenous veins / 2 short saphenous veins
3 recurrences: neovascularisation of the SFJ
Mean age: 58 y.
C2 (CEAP): 100%
Saphenous diameter: 6,3 mm
27. Conclusiones
CHIVA es una estrategia
CHIVA puede ser aplicada mediante diferentes técnicas
El uso de RF en el tratamiento del punto de fuga nos ha
aportado:
Eficacia
Seguridad
Menor agresión
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