aree scientifiche

context of CVI.

17) GIANESINI S., MENEGATTI E., ZUOLO M., TESSARI M., SPATH P., ASCANELLI S., OCCHIONORELLI

S., ZAMBONI P., Laser–assisted strategy for reflux abolition in a modified CHIVA approach, Veins and Lymphatics, 2015, 4: 5246 doi:10.4081/vl.2015.524,

18) ZAMBONI P. et Al.:Oscillatory flow suppression improves inflammation in chronic venous disease

journal of surgical research _ september 2016 (205) 238-245

a b s t r a c t

Background: To assess if suppression of the oscillatory component of reflux may improve the inflammatory phenotype in chronic venous disease (CVD).

Materials and methods: From 193 CVD patients, we selected 54 (13 males, 41 females, CEAP C2-4EpAsPr) for a blinded, case-control prospective investigation. All of them underwent echo-color-Doppler assessment of reflux parameters. In the same patients a blood systemic assessment of 19 inflammatory cytokines was obtained. Follow-up lasted 6 months. The control group (C) was constituted by 21 homogenous CVD patients, unselected and not operated.

Results: Forty-one of 54 patients were excluded from post-operative evaluation in consequence of reported new other inflammatory episodes. Twenty-three (23) completed

the follow up, showing the suppression of the oscillatory component of venous reflux; 4 of the 19 cytokines decreased significantly after the procedure: Tumor Necrosis Factor-a (TNFa), Granulocyte Colony Stimulating Factor (G-CSF), Interferon gamma-induced Protein

10 (IP-10), Interleukin-15 (IL-15). Particularly, TNFa and IP-10 even returned inside a physiological range: 5.3 _ 2.7 to 4.2 _ 2.2 pg/mL (P < 0.003) and from 303.7 _ 168.4 to 254.0 _ 151.6 pg/mL (P < 0.024), respectively. Both cytokines showed a weak but significant

correlation with parameters of oscillatory flow correction. Finally, three cytokines implicated in repair and remodeling of tissue, Epidermal Growth Factor, Monocyte Chemoattractant Protein-1 and Platelet Derived Growth Factor-BB (PDGF-BB), significantly

increased. Our findings are further reinforced by the significant changes of the same cytokines when compared to C group.

Conclusions: The surgical suppression of the oscillatory component of reflux modulates the inflammatory phenotype, suggesting a pivotal role of flow among factors concurring to inflammation in CVD.

19) DEL FRATE R.: Thanks to the CHIVA strategy may the histoarchitecture of great saphenous vein-sparing, make it suitable as graft for bypasses?

Veins and Lymphatics 2019; volume 8:8227

Post-CHIVA regression of anatomical-pathological alterations of the incompetent saphenous trunk

20) ZAMBONI P. et Al.: Alternative saphenous vein sparing surgery for future grafting.

Panminerva Med. 1995 Dec;37(4):190-7.

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