[Research on renal hemodynamics in nephrovascular hypertension].
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Hemodynamics↗
Biomedical subjects
C Spartera
Publications and source records attributed to C Spartera.
Criteria for prognostic evaluation of the results of lumbar sympathectomy: clinical, haemodynamic and angiographic findings.
Lumbar sympathectomy still has an important role in the surgical treatment of occlusive peripheral arterial diseases of the lower limbs located below the inguinal ligament, when the presence of peripheral lesions makes revascularization difficult. A consecutive series of 143 patients who underwent lumbar sympathectomy was considered, and the clinical, angiographic and haemodynamic findings evaluated. Haemodynamic studies on these patients showed a relation between the clinical improvement and the pressure index, measured at the ankle before lumbar sympathectomy. The patients with pressure index values above 0.5 had a symptomatic improvement whereas the patients with a pressure index below 0.3 gave less good results. It is therefore believed that lumbar sympathectomy showed not be considered a second operative choice but an elective operation, especially in patients affected by lesion of the superficial femoral artery, the popliteal artery and its branches, with pressure indices above 0.5 where revascularization is not possible.
Adult↗
[Transcranial Doppler sonography in the pre- intra- and post-operative evaluation of 85 patients undergoing carotid endarterectomy].
PURPOSE: To evaluate the usefulness of transcranial Doppler sonography during carotid endarterectomy. PATIENTS AND METHODS: Pre-, intra-, and postoperative transcranial Doppler was performed in 85 patients who underwent carotid endarterectomy. Intracranial collateral pathways were evaluated preoperatively and continuous monitoring of middle cerebral artery flow velocity was performed during carotid surgery. Transcranial Doppler was repeated in each patient 1 and 7 days thereafter. RESULTS: Values of residual middle cerebral artery flow velocity during preoperative digital compression of the common carotid artery were significantly correlated (r = 0.56; P < 0.001) with those obtained during cross-clamping. Middle cerebral artery flow velocity was significantly lower during cross-clamping with respect to pre-clamping (P = 0.006), in patients with neurologic symptoms (P = 0.001), EEG alterations (P = 0.001), or defective collateral blood supply through the anterior communicating artery (P = 0.01). Postoperative flow velocity values of the MCA were significantly higher at day-1 examinations (P < 0.0001) with respect to preoperative values, and were no more significantly different at day-7. CONCLUSIONS: Transcranial Doppler is a useful method to evaluate the risk of cerebral ischemia during carotid endarterectomy cross-clamping, to identify those patients in which shunt insertion is mandatory, and to evaluate the postoperative effect of carotid endarterectomy on cerebral hemodynamics.
Blood Flow Velocity↗