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In this paper we present our endovascular LASER treatment of mixed shunts. This technique is built according the CHIVA's important principles: diastolic reflux is interrupts at its proximal origin by flush LASER obliteration while centripetal systolic reflux is preserved. In this way, the surgeon interrupts a recirculation pressure loop producing the ambulatory venous hypertension critical to the development of varicose vein symptoms. In this paper we explain how to better understand the intricate venous drainage pathophysiology of mixed shunt and the strategy to approach it using an office-based technique. With the correct strategy and the technological support it is possible to achieve a good functional and aesthetic result to prevent varicosity recurrence. [ABSTRACT FROM AUTHOR]