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Biomedical subjects

B Gossetti

Publications and source records attributed to B Gossetti.

33 records · Page 2Linked to original sources

Isolated symptomatic lesions of the vertebral artery: cure after surgical repair.

Nine patients with uni-or bilateral stenosis of vertebral arteries, not associated with other lesions of supraaortic trunks are reported. They showed a vertebrobasilar insufficiency syndrome not due to other assessable causes. Seven of them underwent surgical treatment always as reimplantation of the vertebral into the subclavian artery. The procedure was unilateral also in cases with bilateral lesions. In all 7 patients a favourable result was obtained: 5 patients recovered completely and 2 showed a marked improvement. The study demonstrates that the surgical repair of symptomatic unilateral lesions of vertebral arteries is able to cure the vertebrobasilar insufficiency syndrome.

Adult↗

Arterial reconstruction of the limbs in poor run off conditions and surgical repair of vena cava with expanded PTFE (IMPRA-grafts).

Seventy eight arterial and venous reconstructions using expanded microporous PTFE (IMPRA-grafts) are reported. This prosthetic material has been employed, by itself or in addition to autogenous vein segments when the saphenous vein was not available or inadequate in length or quality. Long term results show that 83% of vascular repairs are patent up to 36 months post-operatively. Since the prosthesis has been used in vena cava reconstructions, in patients with severe impairment of the distal arterial tree and in some cases in whom previous surgical treatment had failed, these results are favorable and encouraging.

Arterial Occlusive Diseases↗

[Ultrasonics diagnosis of venous thrombosis].

Ultrasound phlebosonometry was employed in the examination of 54 subjects with phlebosonometric acute or recurrent in 20, chronic in 34 cases. The results of one or more phlebosonometric examinations were compared with the phlebograms. It was found that ultrasound investigation was reliable more for high (91%) than for low (65%) lesions and for acute (85%) as opposed to chronic (70%) thrombosis. The method is seen as of great importance in cases of phlebothrombosis, especially in acute femoroiliac forms. Even though it is a qualitative examination, and hence cannot take the place of angiography, it can nevertheless limit the use of the latter in cases where it could be dangerous.

Acute Disease↗

CBF changes after (-)eburnamonine infusion in patients with cerebrovascular insufficiency.

The authors have made a study of CBF after (-)eburnamonine infusion, during angiographic examination of 6 patients with cerebrovascular insufficiency, for a hemodynamic evaluation of the drug efficacy on CBF. The measurement of CBF was done by 133Xe according to the method of Lassen and Ingvar. A correlation between clinical findings, angiographic findings and CBF changes was done to state the employment of (-)eburnamonine in patients with cerebrovascular insufficiency.

Brain Ischemia↗

Prevention of deep venous thrombosis in vascular surgical procedures by LMW-heparin.

The risk of Deep Venous Thrombosis (DVT) in the immediate postoperative period varies from 0.8 to 96% of cases depending on major or minor operations and on age of patients. We have employed 8,000 I.U. AXa/daily of LMW-Heparin injected subcutaneously from one day preoperatively and prolonged for 8 days after surgical procedures in 40 patients operated upon by an aorto-femoral bypass in 25 cases, a femoro-popliteal below the knee in 8 and an extra-anatomical bypass in 7. The onset of DVP in the lower limbs was investigated by clinical examination, venous Doppler pressure evaluation, waveform analysis and echotomography and the 125I-Fibrinogen uptake test. There was no intraoperative increased bleeding and the preclotting of the prosthetic grafts was inaffected. A DVT was detected during the second postoperative day, by means of the 125I-Fibrinogen test in the calf of only one patient (1/40-2.5%), submitted to an aorto-bifemoral bypass, in whom the clinical pattern and ultrasound investigations were negative. The single daily subcutaneous administration has never caused side effects in the site of injection and it seems a real improvement in the heparin treatment. These results emphasize the advantage of the use of LMW-Heparins in patients submitted to arterial surgical reconstructions of the lower limbs for the prevention of the DVT.

Aged↗

Arterial repair of the lower limbs: prevention of prosthetic grafts occlusion by LMW-heparin.

The postoperative thrombosis of prosthetic grafts may be due to many factors: technical errors, poor run-off, prosthetic material, graft length, trauma by subcutaneous tunnellization or repeated microtrauma across the joint areas, evolution of atherosclerotic lesions, emorheological changes. In 50 patients submitted to surgical arterial repair of the lower limbs, we have employed 8,000 I.U. AXa/daily of LMW-Heparin, injected subcutaneously for 6 months after the operations to prevent immediate and late thrombosis. During the follow-up, one patient died, four stopped any treatment and in two the medication was changed. Hence our results are based on 43 cases: 10 patients operated upon by aorto-femoral bypass, 19 femoro-popliteal and 14 extra-anatomical procedures. During the follow-up all the patients were investigated by ultrasounds (pressure measurement, waveform analysis and duplex scanning echotomography); moreover 13/43 (30%) were studied by angioscintigraphy and 11/43 (25.5%) by a conventional or digital subtraction angiography. Thrombosis of the grafts at one year term occurred in none aorto-femoral, in one femoro-popliteal (5.2%) and in one extra-anatomical bypass (7.1%). This figure compares favourably with the results obtained in our experience in the patients treated by a variety of drugs. In such group the incidence of occlusion is 3.9% in aorto-femoral, 9.3% in femoro-popliteal and 11% in extra-anatomical grafts. Those results emphasize the possibility to improve the patency of the grafts in the arterial repair of the lower limbs by LMW-Heparin overall in femoro-popliteal and extra-anatomical areas.

Aged↗

Xenon-133 muscular flow measurements in surgery for arterial disease of the lower limbs.

Muscular flow measurements were carried out in 34 patients with peripheral chronic arterial occlusive disease using the 133-xenon clearance method. The reactive hyperemia technique was preferred to the walking test. All the patients were investigated by angiography and 46 limbs were available for assessment. Control flow measurements were done after treatment in the following groups: arterial reconstruction in ten limbs of nine patients, unilateral lumbar sympathectomy in three and medical therapy in seven. Follow-up was from three to 12 months. The findings of flow measurements were of limited value in identifying the distribution of the arterial disease, but they provided a reliable means to predict the results of direct arterial repair in various procedures. They also proved to be a valuable method to assess the results of surgery. This does not seem to apply to lumbar sympathectomy or conservative treatment.

Aged↗