Abstract
Dear Editor
We thank Professor Franceschi and colleagues for reading and commenting on our manuscript which concentrated on the options for and outcomes of varicose vein intervention Phlebology
We appreciate that pioneering centres have investigated saphenous vein sparing procedures for some time. However, it has not become a widespread procedure with fewer than 50 articles referencing CHIVA available when searching PubMed as of August 2012, many of which are not in English, the language of the authors of our article. Further, the Cochrane Review Protocol referenced was published in February 2012 and therefore not available at the point of submission of article (January 2012). 1
We referenced Parés et al.'s 2 2010 study which showed the beneficial outcomes of CHIVA compared with stripping in the randomized controlled trial setting as it represents the largest trial (n > 150 per trial arm) currently published. The single-centre series by Milone et al. 3 was described in more detail to highlight the importance of experience in an unfamiliar (for many) procedure, and that it may offer better outcomes than traditional open ligation and stripping once the practitioner is confident in the technique.
What is clear is that all methods currently in practice achieve the goal of symptomatic improvement, but for true comparison we would suggest that further studies with quality of life assessment after CHIVA would be appropriate.