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Biomedical subjects

F Benedetti-Valentini

Publications and source records attributed to F Benedetti-Valentini.

33 records · Page 2Linked to original sources
PubMedDate not supplied

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↗
PubMedDate not supplied

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.

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PubMedDate not supplied

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.

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PubMedDate not supplied

Selection for surgery and long-term results in renovascular hypertension.

From 1960 to December 1977, 251 patients with renovascular hypertension (RVH) were observed; 219 were operated upon. Long-term results were assessed in 130 patients. Selection for surgery follows three steps: 1) screening of patients with renal artery disease, which is done by angiography; 2) diagnosis of RVH, which is reached mainly by differential renal function studies and renal vein renin measurements (ancillary methods are intravenous pyelography and sequential scintigraphy; the significance of renin measurements is discussed); and 3) prediction of the results of surgery and choice of technique. An original dynamic test of the authors is employed and reconstruction of the renal artery is the procedure of choice. This is done in the majority of cases by aortorenal bypass grafts using dacron prostheses. Techniques and complications are discussed and comparison with venous autograft is made. Hospital mortality was 3.2%. Overall long-term results were favorable in 78%. Long-term mortality was 6% and occurred mainly in patients who remained hypertensive. Results in atherosclerotic patients are compared with those obtained in fibrous stenoses. Results of renal artery reconstructions were far better than those of nephrectomies and lead us to restrict indications for such a procedure.

Aorta, Abdominal↗