[Arterial impedance in evaluating peripheral arteriopathy].
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Biomedical subjects
Publications and source records attributed to G Nuzzaci.
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A hemodynamic research was carried out by the authors in ten patients affected with upper limb "vibration angiopathy", as well as in ten healthy control subjects. Digital artery flow and systolic, diastolic and mean pressures were measured, and vascular resistances and the so-called "systolic index" calculated, both in basal condition and following hand warming. In patients with "vibration angiopathy" fingers were examined, which on a previous arteriographic study showed the most and the least severe arterial lesions, respectively. No statistically significant differences were detected between the mean values of the hemodynamic indices obtained from the most and the least involved fingers, respectively, as well as between such values and the control subject ones. These results would suggest--even with due reservation on account of the relatively small number of cases and of their different features--that digital artery lesions, as shown by arteriography, have no definite hemodynamic significance. The lack of a statistically significant decrease of the digital artery mean pressure, compared to control subjects, supports the hypothesis that Raynaud's phenomenon in "vibration angiopathy" is not due to a transmural pressure fall. Finally, the lack of correlation between the severity of arterial lesions and Raynaud's phenomenon site suggests that the vasomotion impairment which causes the phenomenon is not related to such lesions.
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The Authors have investigated the significance and the limits of the directional Doppler method in a group of subjects affected by internal carotid obstruction in various sites and degree. On the basis of the obtained results the Authors point out how this method represents a concrete progress in the field of non invasive diagnosis of the insufficiency of this artery.
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The diagnostic value of radioisotopic cerebral angioscintigraphy (R.A.) and of Doppler CW (D.C.W.) techniques to identify stenosis of the internal carotid artery in its extracranial course was studied in 97 patients with ischaemic lesions (50 T.I.A. and 47 Complete Stroke). The results of R.A. and D.C.W. were compared with those of contrast carotid-angiography (C.A.). C.A. revealed stenosis above 50% or complete occlusion in 22% of cases, whereas D.C.W. and R.A. showed flow reduction in 27% and 48% of the cases respectively. In T.I.A., C.A. positivity went down to 8%; D.C.W. to 16%; and R.A. to 34%. In "Complete Stroke" positivity was 36% for C.A.; 41% for D.C.W.; and 62% for R.A. There was a high number of false positive findings with D.C.W. (8) but even more with R.A. (27). False negative findings occurred only in two cases with R.A. These data confirm the diagnostic value of these two noninvasive techniques to identify haemodynamically carotid stenosis. The use of both methods can reduce error due to false negativity. The rather marked frequency of false positivity, particularly with reference to R.A. doesn't affect the diagnostic value of the two methods.