The procedure is performed under local anesthesia. For patient safety and comfort we always have an anesthesiologist in case needed. For this reason it is important that the patient stays 8 hour with nothing by mouth (6H for pure water).
Preoperative exams requested by Doctor Faccini and staff should be ready on the day of surgery. Exams are not always available for viewing on the internet, if possible you should print and take the results with you. IMPORTANT: In the post-operation period the veins are decreasing rapidly or sometimes slowly depending on the case. After decreasing the pressure inside the saphenous vein, the pressure in the diseased venous system decreases as do the size of veins. In most cases the spider veins and collaterals disappear. A few cases some veins are still visible and we may treat them for cosmetic reasons. In this cases, we do laser and injection sclerotherapy to obtain final cosmetic result. That happens with the other methods as well. There is no definitive cure for chronic venous insufficiency, what we do is the maximum to avoid complications of the disease and relapse.
The CHIVA duplex is usually performed the same day and/or the day before the procedure in the office.
According to Brazilian regulations the patient must have information about the procedure and sign the consent form. We have a very explanatory term regarding the surgical techniques of varicose veins that should be well read and doubts asked.
Guidelines after the procedure
How you must have read in the term the main complication after surgeries in general is thrombosis of veins and its consequences. We take great care to avoid it, so the protocol must be followed strictly. The patient must WALK A LOT, starting soon after operation. At least two walks outside a day and many small walks indoors. You can go to the supermarket, shopping or walk on the street.
Patient should drink plenty of water (2 liters a day).
Patient should use medication to avoid deep vein thrombosis in the PO period. Two options are Enoxaparin 40 mg 1 subcutaneous syringe every 24 hours or eliquis 2.5 mg 12 / 12h oral. The number of days varies according to the case, consult the doctor to know how many days (the first dose is still given at the hospital and you should start 24 hours after).
The elastic stockings should be used without removing for 24 hours and then remove to sleep and put on again in the morning. Type ⅞ with compression 20-30 mmHg to be purchased at a specialized store with the leg measured on time. In the postoperative period we use it for 15 days, but in patients with bulky varicose veins we may need a bit more.
Keep your socks in good condition because on long airplane flights varicose patients should wear socks and it lasts for 6 months of continuous use (follow washing instructions), so your stockings will be good for use in your flights for a long time.
The food should be normal, with no restrictions or additions due to the procedure.
The stitches are removed with 6-7 days of PO by the doctor. We usually book the date for you.
The dressings that come out of the operation are made for compression and must remain for 24 hours. After 24h if wetting or soiling occurs, you can remove and put a band-aid or large size nexcare on top to protect the area.
For shower leave the dressing and block it with a platic film (food storage film). if it gets wet remove it, dry lightly and paste a new one.
Usually CHIVA hurts little. Most patients take less than 2 pills for pain and many none. We suggest that you use pain medication that you use and only if it bothers you. The doctor usually prescribes a pill just in case.
If there is large swelling, fever, discharge, or other signs of a problem, call the doctor and/or come to the hospital emergency room to evaluate.
Specific guidelines for patients who live far away
Our suggestion is that the patient stays in Rio Grande do Sul until the points are removed (6-7 days). Not necessarily at Porto Alegre. On the day of the operation and the next day we suggest you stay at Porto Alegre as well as on the 6th day. In the others you can enjoy and help recovery by sightseeing and walking around the region. There are hotels of different price ranges and stars near the clinic and also in Gramado and Bento Gonçalves for the days for the days PO 3, 4 and 5.
In addition, in patients that go flying soon after the operation we extend prophylaxis for DVT for 10 days.