CHIVA: Non-Destructive Venous Insufficiency Platform

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The Global CHIVA Program is a groundbreaking medical education, training, and assessment platform for venous insufficiency diagnosis and treatment.  

This program establishes the first globally recognized and certified standard for mastering the CHIVA technique, enabling healthcare practitioners worldwide to address venous diseases.  

In collaboration and coordination with Dr. Smile Medical Group, Inteleos is set to launch the program in 2025.  

Sign up and be the first to receive program updates including program release dates. 

CHIVA, first described by Professor Claude Franceschi in 1988, is a non-destructive alternative to common procedures for varicose veins. The aim of the technique is to lower transmural pressure in the superficial venous system and avoid destruction of veins while decreasing pain, cost, and nerve damage 

CHIVA is the French acronym for “Cure conservatrice et Hemodynamique de l’Insuffisance Veineuse en Ambulatoire” (Conservative and Hemodynamic treatment of Venous Insufficiency in outpatients).

About Dr. Smile Medical Group

Dr. Smile Medical Group, based in Shanghai, is a leading medical organization focusing on vascular clinical practices and venous disease diagnosis and treatment. Dr. Smile Medical Group owns health service institutions, medical education platforms, medical technology, and medical devices R&D centers.

CHIVA: Tiered Framework 

The goal of the Global CHIVA Program is to establish one cohesive framework to support CHIVA practitioners to address the health needs of patients with venous diseases on a global scale through a holistic and multidimensional, tiered approach.

Tier 1: Knowledge-Based Platform 

Focus on delivering knowledge-based education and training content virtually through a customized Global CHIVA online learning management system (LMS), with the goal of building a foundational understanding of CHIVA and related medical knowledge.  

The virtual online delivery platform includes e-learning modules, webinars, and other educational and training materials accessible to a wide audience around the globe.  

Registered students and trainees will be awarded Tier 1 Certification only after successfully completing the required education and training content and then passing the assessment via the Global CHIVA Program LMS platform.  

A Tier 1 Certificate is the prerequisite for entrance into the Tier 2 and 3 Programs.  

Tier 2 and Tier 3: Clinic-Based Platforms 

Training and education in qualified clinics will provide hands-on training and practical experience for eligible healthcare professionals. This will involve on-site training sessions, simulation exercises, and workshops in appropriate healthcare settings.  

Tier 2 Program will focus on observation and simulation exercises in the clinical setting. 

Tier 3 Program will focus on hands-on performance under supervision.  

Tier 4: Independent Practitioner Platform 

Designed to facilitate the transition of eligible and qualified participants into independent practitioners.  

This will involve advanced on-site training, mentorship programs, and certification processes to help practitioners to perform autonomously comprehensive health interventions for patients in need.  

Independent medical practitioners must meet all necessary legal requirements in their applicable countries and regions. 

The CHIVA examination covers the following content areas. All percentages are an approximate distribution of the questions across the content areas.

CHIVA Content Outline ​(Please click on “CHIVA Content Outline” for the detailed Content Outline in PDF-Printable format).

Intake (14%)
Pre-Operative Haemodynamic Mapping (38%)
During the Procedure (16%)
After the Procedure (12%)
Follow Up Visits (20%)

Please note: All percentages are approximate.

Your score report will display and include performance feedback for these content areas.

Periodically, APCA conducts a CHIVA Practice Analysis and updates the CHIVA examination to reflect the frequency and importance of CHIVA tasks being performed by physicians.

View the 2022 CHIVA Practice Analysis Results.

The Global CHIVA Advisory Panel consists of CHIVA subject matter experts from around the world who have contributed their expertise to support the development of the CHIVA global certification program. The panel is used as a sounding board and members may be asked to make recommendations or to provide important insights related to the CHIVA practice.

Name Country
Dr. Maria Caminati Italy
Dr. Massimo Cappelli Italy
Dr. Roberto Cuaranta Spain
Dr. Michel Dadon France
Dr. Jianping Deng China
Dr. Luca De Siena Italy
Dr. Roberto Delfrate Italy
Dr. Xin Du China
Dr. Stefano Ermini Italy
Dr. José María Escribano Spain
Dr. Felipe Puricelli Faccini Brazil
Dr. Davide Foresti Italy
Dr. Guglielmo Fornasari Italy
Dr. Claude Franceschi France
Dr. Gelfrido Galizi Italy
Dr. Sergyi Kryzhanovskyi Ukraine
Dr. Andres Jorge Kupelian Argentina
Dr. Thanh-Phong Le Vietnam
Dr. Erika Mendoza Germany
Dr. Domenico Migaldi Italy
Dr. Fausto Passariello Italy
​Dr. Mauro Pinelli Italy
Dr. Juha Pitkaenen Finland
Dr. Manuel Eugenio Senín Fernández Spain
Dr. Qiang Zhang China
Dr. Xiaoyin Zhu China

(If you are a member and would like your name removed from this list, please contact volunteer@inteleos.org)

Are you an expert in CHIVA who would like to become part of the Advisory Panel? Contact us at volunteer@inteleos.org.

Learn more about the CHIVA approach to treating varicose veins directly from Dr. Smile.

Dr. Smile Vein Centers in China: Making Chiva Strategies with POCUS for the Treatment of Varicose Veins

This presentation by Dr. Smile, of the Dr. Smile Medical Group in China, gives an overview of how he has applied CHIVA technology to treat lower extremity varicose veins. A key part of this is the use of ultrasound hemodynamic assessments to develop treatment plans. This approach reduces venous pressure by recorrecting reflux and preserving an intact venous network.

The veins in the lower extremities are examined by the doctor using an ultrasound device in office. The inspection contents include whether the deep and superficial veins are patency, whether there is valvular regurgitation and the location of the escaping points and re-entry points.

Patients with varicose veins undergo outpatient treatment under local anesthesia. Dr. Smile Medical Group has established venous disease centers in 13 cities in China with the same standards and procedures, providing for safer and more efficient minimally invasive treatment for thousands of varicose vein patients every year.