Biomedical subjects

J Rinieri

Publications and source records attributed to J Rinieri.

4 recordsLinked to original sources

PubMedDate not supplied

[Theory and practice of hemodynamic treatment of deep venous insufficiency caused by valve absence].

HDDVI is a form of surgical treatment which, using a series of selective ligatures, is aimed at curing deep venous insufficiency due to valve absence. There are two fundamental principles: an incompetent vein ensures no venous return in standing position and is the site of reverse circulation; this ineffective vein develops a collateral circulation because of the increased pressure which it produces. However, this parallel circulation is in fact neutralised by the diseased vein which forms a retrograde shunt. Section ligatures are suggested taking into account single main veins with minimal collaterals (popliteal vein, femoral vein, external iliac vein) for which patency is essential. This novel theory is based upon physical, and anatomical and functional clinical arguments. The strategy is discussed in terms of the hemodynamic map of the deep veins obtained by orthostatic duplex Doppler. Confirmation that the theory is well-founded appears to be provided by the first cases treated.

Collateral Circulation↗

PubMedDate not supplied

[Functional exploration of the deep venous system by duplex].

The development of new direct methods for treatment of deep venous insufficiency requires improvement of the ultrasonographic investigation of valve function. The combination of imaging and pulsed Doppler provides more accurate diagnoses and can be used to establish deep venous hemodynamic cartography. Four essential rules must then be followed: an examination in standing position, proximal decompression tests, examination by one third segments and by thirds of each segment, analysis of the forgotten veins of the leg (soleus, gemellar) and thigh (profunda femoris, quadriceps, posterior ischiatic anastomotic flow) and of the deep muscular anastomoses. The hemodynamic direction of each feature of the venous map is then noted. This investigation enables the following in the context of disease: the diagnosis of deep venous pain affecting an apparently non-varicose area; precise monitoring of the post-thrombotic status of a deep vein, avoiding diagnostic errors related to a painful repermeation syndrome; preselection of cases of deep venous insufficiency suitable for anatomical surgical treatment or a hemodynamic technique (CHIVP) as indicated by the deep hemodynamic cartography which this investigation makes possible.

Humans↗

PubMedDate not supplied

[Multi-vessel venous perforating varices].

Using ultrasonographic data, the author describes the existence of venous perforators communicating between deep veins and superficial veins and with several distinct channels. Perforators are classified into three types according to whether they have multiple axes on the surface, deep, or both together. There are two sub-types, A and B, of perforators with multiples axes on the surface, according to whether they join up with the same or different superficial veins. These multi-channel perforators represent a risk of failure in excision or conservative surgical treatment which may result in hemodynamic overload being imposed on another venous sector, and of the development of telangiectasia or even of veno-venous shunts. Such perforators may behave in the same way as angiomas and sclerosing injections would then be preferable to a surgical solution.

Humans↗

PubMedDate not supplied

[Contribution of percutaneous trinitrin in the treatment of resistant ulcers].

The author reports the place of Percutaneous Trinitrin in the treatment of arterial or venous ulcers. Ten ulcers resistant to specific treatments responded quite favorably to this medication. Its indications could therefore be extended, not only to the treatment of recurrent ulcers, but to hyperalgic ulcers or to the pre-ulcer syndrome. The latter is compared to the angina preceding infarction. The hypothesis of a self-sustained lift of the vascular spasm, in spite of the correction of its origin, is therefore raised.

Administration, Cutaneous↗