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A Veltri

Publications and source records attributed to A Veltri.

9 recordsLinked to original sources

[Liver transplantation: diagnostic imaging in the preoperative assessment].

The correct selection of patients for liver transplantation, which is essential for surgical success, requires thorough radiological evaluation. The authors present their experience on 94 pretransplant adult patients that underwent a total of 251 diagnostic exams (Doppler US, CT, angiography and cholangiography) and interventional radiology maneuvers (biopsy, chemoembolization, biliary drainage). Three sclerosing cholangitis, 3 Budd-Chiari syndromes and 20 hepatocellular carcinomas in cirrhotic patients were identified; venous collaterals were present in 62.7% of the cases, 12.8%, of which had important spontaneous porto-systemic shunts; 6 patients had portal thrombosis; 20 arterial variations were found. Interventional maneuvers were useful and free of complications. US, CT and angiographic findings of each patient were compared. Integrating informations from different exams allowed a significant increase in the accuracy of diagnostic conclusions. Thanks to interventional maneuvers 5 patients could be selected for transplantation (hepatic arterial lipiodolization stopped the growth of 4 hepatic neoplasms; 2 infected fluid collections were sterilized by percutaneous US-guided drainage and topic therapy.

Adult

[Liver transplantation: role of the radiologic methods in the postoperative period].

Some complications of liver transplantation appear as aspecific clinical and blood test abnormalities; others--e.g., hepatic artery thrombosis in the immediate postoperative period and stenosis of the biliary anastomosis before T-tube removal--require early diagnosis. These considerations justify the need of frequent radiologic examination in both the complicated course and the follow-up. The authors report their experience in 59 adult patients submitted to liver transplantation for irreversible liver disease in advanced stage (49 with cirrhosis, 10 with HCC; 5 with cholestatic hepatopathy; 3 with fulminant hepatitis; 1 with Budd-Chiari syndrome; 1 with metastatic APUDoma). Two hundred and sixty-three radiological examinations were performed (Doppler US, CT, angiography and cholangiography) which showed numerous early and delayed complications: 13 of them were treated with interventional radiology maneuvers (US-or CT-guided percutaneous drainage of fluid collections, biliary drainage, bilioplasty, arterial transcatheter embolization). Our results demonstrate that diagnostic and operative radiology are essential for the success of liver transplantation; integrated imaging is particularly important in the diagnosis of complications, while interventional radiology techniques can be usefully employed in their treatment.

Adult

[Percutaneous transjugular intrahepatic portosystemic shunt (TIPS). The preliminary experience and proposal of a new method].

A new interventional procedure employing metallic stents has been recently suggested to perform percutaneous portosystemic shunts in the treatment of variceal bleeding in portal hypertension; the technique is called TIPSS (transjugular intrahepatic portosystemic stent shunt). This percutaneous treatment presents several advantages over surgery: the shunt diameter can be calibrated according to the degree of portal hypertension; moreover, TIPSS can be performed in patients waiting for liver transplantation because it does not alter the vascular anatomy of liver. The original technique employed transhepatic portography. In this paper the authors report on their personal experience and present their series of 4 patients with portal hypertension and variceal bleeding, in whom TIPSS was performed utilizing noninvasive US guidance. Variceal bleeding was successfully treated in all patients and variceal distension was also obtained.

Adult

[Role of ultrasonography in the assessment of lymphoma localized in the abdomen].

Both prognosis and treatment of lymphomas depend strictly on both clinical staging and histologic classification. The role of US was investigated in the evaluation of patients affected with abdominal lymphoma. To this purpose, 52 patients affected with abdominal lymphoma underwent US and CT studies during staging, treatment, or follow-up. A comparison of the results of the two methods shows that the systematic use of US allows 5% of lymph nodes missed at CT to be demonstrated, together with hepatic and splenic involvement also undetected by CT. It is true, however, that the limited number of cases does not allow this result to be correlated with the histopathologic type of lymphopathy. US has also been the examination of choice to evaluate response to chemotherapy and to study suspected relapses. In the authors' opinion, US should become a complementary technique to CT in the staging of abdominal lymphomas.

Abdominal Neoplasms

[Dynamic cavernosography. A proposed new method].

The excessive blood outflow from the corpora cavernosa during erection ("venous leakage") is a frequent cause of impotence. Dynamic cavernosography, a recent technique, is able to both evaluate such venous leakage and detect the veins concerned. After a critical review of the literature and on the basis of their own experience (64 cases), the authors suggest a 2-phase method. A conventional cavernosography is performed and flows of physiological solution necessary to induce and maintain an artificial erection are separately measured. Subsequently, only the patients with increased flow rates undergo a second angiography of the corpora cavernosa and drainage paths, after being given and intracavernous injection of papaverine. A simple, more rational and less invasive examination can thus be performed. All useful parameters can nevertheless be examined when surgical/radio-interventionist treatment is considered.

Adolescent