Papers by Alessandro Frullini
Dermatologic Surgery, Jun 1, 2003
Giornale italiano di cardiologia, 2013
Revista panamericana de flebología y linfología, 2001
Escleroterapia de las venas varicosas en miembros inferiores mediante espuma esclerosante de acue... more Escleroterapia de las venas varicosas en miembros inferiores mediante espuma esclerosante de acuerdo a Tessari. Experiencia preliminar. El objetivo de este trabajo es evaluar la eficacia a corto plazo y la seguridad de la espuma esclerosante obtyenida del sulfato tetradecil-sodico (Fibro-Vein) con el metodo de Tessari en el tratamiento de telangiectasias y venas varicosas de miembros inferiores...Se obtuvo un alto porcentaje de exito inmediato en el grupo tratado, con la rapida aparicion del espasmo masivo en la mayoria de los casos y la obliteracion de todos los 61 tramos venosos medianos y grandes observada 1 es despues...La espuma esclerosante segun Tessari basada en Fibro-Vein ha demostrado, en esta experiencia piloto, ser un trratamiento efectivo y seguro para venas varicosas de mediano y gran tamano. Su papel en telangiectasias queda por definirse
Minerva chirurgica, Jan 30, 1991
The Authors describe a case of elastofibroma in its typical location; the most interesting aspect... more The Authors describe a case of elastofibroma in its typical location; the most interesting aspect of this lesion is the microscopic appearance. The benignity of this lesion is absolute, from the clinical and microscopic points of view.
Phlebology / Venous Forum of the Royal Society of Medicine, 2011
Visual and neurological disturbances have always been reported following liquid sclerotherapy (LS... more Visual and neurological disturbances have always been reported following liquid sclerotherapy (LS) for venous insufficiency. In 1993 Cabrera introduced foam sclerotherapy (FS) using a detergent sclerosant as Lauromacrogol 400 or sodium tetradecyl sulphate. Several authors have reported with FS an increased incidence of such transient visual disturbances and neurological complications. This has been associated with gas or air used to generate the sclerosing foam. The frequent association of the presence of a patent foramen ovale, a common condition in normal population, and such complications has led several authors to consider neurological and visual disturbances as paradoxical gas embolism. We are introducing a new pathogenetic hypothesis for sclerotherapy complications. Medical literature shows evidence of a clear relationship among cerebral and retinal vasospasm, migraine and intimal irritation. We think that the irritating sclerosant agent may stimulate a significant release of ...
Il Giornale di chirurgia
A good diagnostic protocol as well as a proper preparation to surgery and a careful intensive obs... more A good diagnostic protocol as well as a proper preparation to surgery and a careful intensive observation (associated if necessary with an intensive therapy) can lead to a better prognosis in major surgical procedures or routine surgery in poor risk patients. Candidates to ICU are divided in three classes: type A is a stable patient requiring constant monitoring for high probability of complications, type B is still a stable patient who needs an intensive nursing; finally type C is an instable patient who requires a true intensive care. In the surgical department of USL 20/B Figline Valdarno (FI) a postoperative Intensive Care Unit (ICU) has been established in the last three years: a three-bed section with its own staff is located in the surgical department itself. In 37 months 467 operated patients requiring intensive observation or intensive therapy have been admitted.
Il Giornale di chirurgia, 1992
A series of 11 patients (3 males and 8 females, mean age 63.4 yrs.) suffering from gallbladder ca... more A series of 11 patients (3 males and 8 females, mean age 63.4 yrs.) suffering from gallbladder cancer has been reviewed. Authors' purpose in reviewing their experience was to identify factors either in patient characteristics or treatment, that may influence statistic data. Symptoms, signs, laboratory and imaging studies were uniformly unhelpful in determining the diagnosis. Early diagnosis at a stage amenable to surgical excision remains the only therapeutical possibility.
Phlebology: The Journal of Venous Disease, 2013
Aim Sclerotherapy is the targeted chemical ablation of varicose veins by intravenous injection of... more Aim Sclerotherapy is the targeted chemical ablation of varicose veins by intravenous injection of a liquid or foamed sclerosing drug. The treated veins may be intradermal, subcutaneous, and/or transfascial as well as superficial and deep in venous malformations. The aim of this guideline is to give evidence-based recommendations for liquid and foam sclerotherapy. Methods This guideline was drafted on behalf of 23 European Phlebological Societies during a Guideline Conference on 7–10 May 2012 in Mainz. The conference was organized by the German Society of Phlebology. These guidelines review the present state of knowledge as reflected in published medical literature. The regulatory situation of sclerosant drugs differs from country to country but this has not been considered in this document. The recommendations of this guideline are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in...
Dermatologic Surgery, 2011
BACKGROUND Foam sclerotherapy is an increasingly popular modality in varicose vein treatment. Our... more BACKGROUND Foam sclerotherapy is an increasingly popular modality in varicose vein treatment. Our previous work showed that the half-life of room air foam varied according to the percentage and type of sclerosant solution. MATERIALS AND METHODS A plastic connector was used to create foam made from a combination of 0.25%, 0.50%, and 1% sodium tetradecyl sulfate (STS) and room air, carbon dioxide (CO 2), oxygen (O 2), or a mixture of CO 2 and O 2. To measure foam stability, the foam half-life was defined as the time it took for half the original volume of sclerosing solution to settle. RESULTS Half-life varied according to sclerosant concentration when room air, O 2 , or a mixture of CO 2 and O 2 was used for foam creation but not when CO 2 was used. Room air foam is more than 3 times as stable as CO 2 foam and 1.5 times as stable as a mixture of CO 2 and O 2. CONCLUSIONS CO 2 foam half-life did not vary according to sclerosant solution concentration, though room air, O 2 , and CO 2 /O 2 did. The half-life of room air foam is more than 3 times as long as that of CO 2 and 1.5 times as long as that of a mixture of CO 2 and O 2. Foam half-life for room air and O 2 are similar at low concentrations of STS but differ at higher concentrations.
Dermatologic Surgery, 2011
Dermatologic Surgery, 2001
background. Recently a new method of using a foam sclerosing agent for the treatment of leg veins... more background. Recently a new method of using a foam sclerosing agent for the treatment of leg veins has been described. We present a pilot study of a new technique for producing the sclerosing foam (Tessari's method) (SFT) and its use in sclerotherapy of major and minor varicosities. objective. A preliminary multicenter experience of sclerotherapy performed by means of this new kind of sclerosing foam made of purified sodium tetradecylsulfate is described. The authors evaluated the safety and efficacy of different doses and concentrations of the drug as well as different methods of preparing the foam in addition, the results of this technique were evaluated. methods. Over a 6-week period the three authors performed sclerotherapy or duplex-guided sclerotherapy using SFT, treating 77 patients. The SFT was formed using a three-way stopcock and two syringes, mixing air with liquid sodium tetradecylsulfate to create a foam. Each author used different concentrations (0.1-3%) and doses (2-8 ml) of SFT according to the size and number of the veins. Alternate methods of preparing the foam were examined as well. Seventy percent of the sclerotherapy sessions were performed on either the long or short
Dermatologic Surgery, 2011
BACKGROUND What little research has been done on methods of venous valve function recovery with r... more BACKGROUND What little research has been done on methods of venous valve function recovery with radiofrequency has had disappointing results. Valvuloplasty has some supporters, but the majority of physicians do not consider it a valid therapeutic option. OBJECTIVE To test a new method of treating varicose veins based on their collagen structure. This procedure it is not a thermal treatment, but it is fast, with significant shrinking and preservation of the endothelium. MATERIALS & METHODS In the laboratory, we subjected greater saphenous vein specimens to irradiation with a blue light-emitting diode generated (wavelength 450-480 nm) while a riboflavin solution (vitamin B2) was administered. The riboflavin acts as a cross-linking agent, and the blue light as the activator. In this photo-induced reaction, oxygen singlet is produced with oxidative deamination, forming new covalent bonds between collagen fibrils and water. RESULTS In venous specimens, we demonstrated fast and significant shrinkaged without histologic evidence of endothelial damage and with evident change in mechanical properties of varicose veins. CONCLUSIONS Photochemically induced collagen cross-linking to restructure varicose veins is only a research field but may become an important tool for recovery of vein diameter and valve function.
Dermatologic Surgery, 2002
To review the use of sclerosing foam in the treatment of varicose veins, to describe the differen... more To review the use of sclerosing foam in the treatment of varicose veins, to describe the different techniques of foam preparation, and to report the complications of our 3-year experience with this treatment. From November 1997 to the end of October 2000, 453 patients were treated with a sclerosing foam for large, medium, and minor varicosities with sodium tetradecylsulfate (STS) or polidocanol (POL). A first group of 257 patients (90 for minor varicosities and 167 for medium to large veins) received a sclerosing foam according to the Monfreux technique. From December 1999 to October 2000, 196 patients were treated with a sclerosing foam prepared according to Tessari's method (36 for minor size veins or teleangectasias and 170 for medium-large veins). Every patient was studied with (color-flow) duplex scanning before and after the treatment and large vein injections were administered under duplex guide. The immediate success rate was 88.1% in the first group for the medium-large veins. In the same districts we registered an early success rate in 93.3% for the patients treated with the Tessari's method. The complication rate (mostly minor complications) was 8.5% in the first group and 7.1% in the second group. The use of sclerosing foam may become an established therapy in the treatment of varicose veins with a high success rate, low cost, and low major complication rate. According to our actual experience and knowledge, the safe amount of foam should not exceed the 3-ml limit, but further advancements could come from standardization of the foam preparation technique.
Dermatologic Surgery, 2003
Journal of Theoretical and Applied Vascular Research
Objective To study the incidence and the possibility of preventing thrombotic complications durin... more Objective To study the incidence and the possibility of preventing thrombotic complications during major sclerotherapy for venous insufficiency of lower limbs. Methods A total of 2489 sclerotherapy sessions were performed on 2010 patients. 1087 sessions (43.7%) were carried out without heparin prophylaxis while in 1402 sessions (56.3%) a prophylaxis with low molecular weight (LMWH) was used. Thrombotic complications were divided into a) post sclerotherapy transient extension (POSTE) if they consisted of a simple extension of sclerotherapy, and b) deep venous thrombosis (DVT) when the complication occurred in a location separate from that of sclerosis. Results The overall incidence of a thrombotic complication was 0.52%. Out of 2489 sessions, 8 cases of POSTE (0.32%) and 5 thromboses of a gastrocnemius vein (0.2%) were diagnosed The most significant figures were reached in the great saphenous vein (GSV) subgroup, where the incidence of complications was 1.91% without prophylaxis and ...
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2003
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Dermatologic Surgery, 2003
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Papers by Alessandro Frullini