Haemodynamic Surgery versus Conventional Surgery in Chronic Venous Disease: A multicenter retrospective study.

Aim. Chronic venous disease (CVD) is a common disease with a high prevalence in western countries. Standard open vari- cose vein surgery, usually sapheno-femoral junction ligation, great saphenous vein stripping and multiple phlebectomies, has been used to treat varicose veins for a long time. Within the last decade new alternatives to surgical treatment have been developed such us hemodynamic surgery. Aim of this study was to compare hemodynamic strategy versus stand- ard open surgery. Methods. A retrospective multicenter study, between 1994 and 2012, was conducted; 11026 patients (4051 M; 6975F) with CVD were surgically treated for their conditions (me- dian age 45.5 years; age range 21-67); 6044 were treated with CHIVA procedure (Group A) and 4982 were treated with Stripping procedure (Group B). All patients were followed- up for the following parameters: pain; edema; ectasia; pig- mentation; duplex ultrasound controls; recurrence rate. Results. The median follow-up was 9 years for both groups. Duplex controls showed in Group A (CHIVA) respect to Group B (stripping), from the very beginning of follow-up, an optimal improvement of hemodynamic situation. Disappear- ance of symptoms and signs was more evident in Group B (stripping) compared to Group A (CHIVA) at the early follow- up. In the middle and in the late follow-up, a higher number of patients of Group A (CHIVA) showed an improvement of all symptoms and signs respect to Group B (stripping). Conclusion. Hemodynamic surgery, compared to conven- tional surgery, seems to improve results improving clinical and instrumental conditions of treated patients reducing also recurrence of varicose veins.