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Biomedical subjects

D Gasparini

Publications and source records attributed to D Gasparini.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Splenic abscesses. Their percutaneous treatment and the role of the interventional radiologist].

Percutaneous abscess drainage is not as common in the spleen as in other anatomical sites, probably because of an uncontrollable fear of bleeding. Five cases of intrasplenic abscess drainage are presented. A double-way 12/14-F vanSonnenberg catheter was percutaneously inserted under CT guidance in four patients and under US guidance in one patient. Orthogonal scout CT views were useful to check the correct positioning of the drainage. In three patients the maneuver was successful, with no recurrence at follow-up at 12, 16 and 24 months, respectively. In one patient with a splenic abscess due to iatrogenic ischemic necrosis, the drainage allowed delayed surgery after relief of symptoms. Another patient died of sepsis five days after multiple well-functioning drainages. No early or late complications occurred. Bleeding was never observed in our series and there are no recent literature reports on this complication. Whenever it occurs, bleeding can be treated with selective embolization. In our experience, the percutaneous drainage of splenic abscesses, performed by the radiologist, should be considered the treatment of choice in these cases.

Abscess↗
PubMed1993

Thrombocythemia and thrombosis of the adrenal vessels.

The authors describe a case of primary thrombocythemia and thrombosis of the adrenal vessels which they were able to examine by arteriography of the renal and adrenal arteries, by adrenal CT and at autopsy following the patient's death. The available research data and hypotheses concerning the pathogenesis of thrombosis and hemorrhage in thrombocythemia are reviewed, but the relationship between platelet number and function and the incidence of thrombotic and hemorrhagic complications has not yet been clearly established. Pathogenesis of thrombosis and hemorrhage in suprarenal vessels is not clear and the majority of authors postulate early venous damage.

Adrenal Glands↗
PubMed1992

[Role of percutaneous angioplasty in keeping vascular access for hemodialysis].

The stenoses of anastomosed vessels or of implantation grafts are among the most frequent causes of insufficiency of vascular hemodialysis accesses. Percutaneous angioplasty allows the interventional radiologist too to participate in the salvage of shunts. From 1985 to 1991, 46 patients underwent the procedure. Angioplasty could be performed in 43 of them, and had to be repeated in some cases because of either relapse or malfunctioning new vascular access. On the whole, 59 maneuvers were performed, and 96 stenoses treated, 71 in Brescia-Cimino fistulas and 25 in Gore-Tex prostheses. The optimized standard technique employs access through the efferent vein and a diagnostic evaluation after blocking the flow with an inflatable cuff; 2-3 distensions lasting 2-3 minutes are performed with a 3.5-4 mm x 20 mm balloon catheter for the anastomosis. One or more 15-20-minute distensions follow, with a 6-8 mm x 20-40 mm Zijlstra balloon catheter (Schneider) for the lesions in the efferent vein. Our initial success rate was 88.7% (55 of 62 procedures). Follow-up results at 3, 6, 12, 24 months proved that for this type of lesion, which is usually supported by fibrosis and endarterial hyperplasia, estimated relapse rates exceed 50% in the first year and are lower than 10% a year in the following years. Complications are quite rare and can be partly prevented if the correct indications are followed, overdistension is avoided and the proper material is used. On account of the good results it yields, of its relative simplicity and of the very low incidence of complications, angioplasty should be considered as the treatment of choice for stenoses and their relapses in vascular hemodialysis accesses. As for treatment protocol, angioplasty is not a procedure to occasionally replace surgery, but a therapeutic approach which can be repeated at regular time intervals and can prolong the life of hemodialysis fistulas, thus delaying surgical reconstruction.

Angioplasty, Balloon↗
PubMed1991

A comparison of scintigraphy, thermography, ultrasound and phlebography in grading of clinical varicocele.

Varicocele, a varicosity of the pampiniform plexus, usually on the left side, is a common urologic problem. It may be associated with symptoms of local discomfort or abnormal spermatogenesis. Internal spermatic vein phlebography is the "gold standard" investigative technique, but it is invasive. Noninvasive studies include: labeled blood-pool scintigraphy, thermography and ultrasound. Two hundred sixty-three patients were investigated with various combinations of these modalities. The degree of abnormality for each modality was graded semiquantitatively and the results compared. In addition, the results of semen analysis were correlated to imaging results. Ninety-six patients were investigated with all four tests (scintigraphy, thermography, ultrasound and phlebography). The correlation of positive phlebography to positive scintigraphy was 98%, to thermography 100% and to ultrasound 98%. The concordance (grade for grade) was 71% for scintigraphy, 68% for thermography and 62% for ultrasound. There was no obvious correlation between abnormalities of semen analysis and grading of varicocele. We conclude that the diagnostic accuracy and grading of severity by noninvasive techniques (including scintigraphy) compare very favorably with that of phlebography. Moreover, scintigraphy allows the noninvasive evaluation of reflux through the internal spermatic vein, which may be useful in planning therapy.

Adult↗
PubMed1990

[Isolated jejunal angiomatosis. A rare cause of intestinal hemorrhage].

The Authors report a case of solitary small bowel angiodysplasia and emphasise the rarity of this site. The importance of angiography is stressed in terms of its fundamental role in the diagnostic process and in its ability to evaluate not only the site but the extension of this type of lesion, thus enabling a surgical approach to be defined.

Aged↗
PubMed1989

[Embolization in the therapy of hemoptysis. The results of a combination of Spongostan/sclerosing drugs and the role of electrocoagulation].

The author's purpose was to evaluate the efficacy of therapeutic embolization in pulmonary hemorrhage performed with fibrin foam (Spongostan) suspended in sclerosing agents (hydroxy-polyethoxy-dodecane 3%, or natrium morruate 5%), and electrocoagulation (Biotrol, spa) as an alternative to surgery. Twenty patients were embolized: 17 with fibrin foam and sclerosing agents only, 2 with the addition of electrocoagulation and a Gianturco coil respectively, and 1 with electrocoagulation alone. The follow-up ranges from 3 to 42 months (average 22). A patient affected by aspergilloma died a few days after hemoptysis. The patient treated by electrocoagulation alone suffers from periodical hematic expectoration (spitting). The remaining 18 patients have not shown any pathological findings. In 2 cases the arterial occlusion was confirmed by angiography, while in 1 case partial arterial recanalization was observed. Such a finding was due to the vessel dimensions and to hyperflux values. In similar cases, obstruction must be completed by different techniques (e.g. Gianturco coils, electrocoagulation, detachable balloons, etc.). The absence of flux resulting from embolization improves electrocoagulation efficiency, which should be considered as the technique of choice. Even though additional trials are needed, the techniques have proven quite reliable and suitable to replace surgery in low-aggression lesions.

Adult↗
PubMed1987

[Evaluation of the results of various technics of non-surgical therapy of varicocele].

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.

Adolescent↗