Claude Franceschi (born October 12, 1942) is an angiologist French MD.

Background

After

Shigeo Satomura was a Japanese physicist credited with introducing the ultrasonic Doppler techniques to practical medical diagnostics in the 1950s. These techniques made possible non-invasive monitoring of blood flow in the human body. Life Satomura was born ...

who detected for the first time the

blood flow Hemodynamics American and British English spelling differences#ae and oe, or haemodynamics are the Fluid dynamics, dynamics of blood flow. The circulatory system is controlled by homeostasis, homeostatic mechanisms of autoregulation, just as hydrau ...

with a

Doppler Ultrasound Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of a ...

machine, Gene Strandness measured the blood pressure at the

ankle The ankle, the talocrural region or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint. The ...

(1967), Léandre Pourcelot proposed the

Arterial resistivity index The arterial resistivity index (also called as Resistance index, abbreviated as RI), developed by Léandre Pourcelo is a measure of pulsatile blood flow that reflects the Vascular resistance, resistance to blood flow caused by microvascular bed di ...

(1974), and Gosling the

Pulsatility index Hemodynamics or haemodynamics are the dynamics of blood flow. The circulatory system is controlled by homeostatic mechanisms of autoregulation, just as hydraulic circuits are controlled by control systems. The hemodynamic response continuously mo ...

(1974). Claude Franceschi then tried to analyze more exactly the hemodynamic meaning of the Doppler signal wave from normal and diseased

vessels Vessel(s) or the Vessel may refer to: Biology *Blood vessel, a part of the circulatory system and function to transport blood throughout the body *Lymphatic vessel, a thin walled, valved structure that carries lymph *Vessel element, a narrow wat ...

. He published the results at numerous conferences and in the French book "''L'Investigation vasculaire par ultrasonographie Doppler''" ("Vascular Doppler ultrasound investigation") in 1977.

Works

Franceschi's major work was to match the principles of

fluid mechanics Fluid mechanics is the branch of physics concerned with the mechanics of fluids (liquids, gases, and plasma (physics), plasmas) and the forces on them. Originally applied to water (hydromechanics), it found applications in a wide range of discipl ...

with arterial and venous hemodynamics. After studying the correlations between the

Doppler ultrasound Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of a ...

radiological In physics, radiation is the emission or transmission of energy in the form of waves or particles through space or a material medium. This includes: * ''electromagnetic radiation'' consisting of photons, such as radio waves, microwaves, infr ...

and

surgical Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

data, he laid down the

methodological In its most common sense, methodology is the study of research methods. However, the term can also refer to the methods themselves or to the philosophical discussion of associated background assumptions. A method is a structured procedure for bri ...

and

semiotic Semiotics ( ) is the systematic study of semiosis, sign processes and the communication of Meaning (semiotics), meaning. In semiotics, a Sign (semiotics), sign is defined as anything that communicates intentional and unintentional meaning or feel ...

bases of vascular Doppler ultrasound. * In 1977, he published the very first book in the world on Vascular Doppler Exploration (Vascular investigation by Doppler ultrasound) then translated into Italian and Spanish, in which he describes the hemodynamic principles and their expression in terms of Doppler signal. This data remains the undisputed reference for the

stenosis Stenosis () is the abnormal narrowing of a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' as a term is usually used when narrowing ...

quantification and a quality diagnostic. In particular, he worked on the criteria of arterial stenosis of limbs and carotids, Carotid pre-

thrombosis Thrombosis () is the formation of a Thrombus, blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (thrombocytes) and fib ...

, the Pressure-Perfusion Index (Franceschi Index), the Carotid Ratio and the exploration of the

Circle of Willis The circle of Willis (also called Willis' circle, loop of Willis, cerebral arterial circle, and Willis polygon) is a circulatory anastomosis that supplies blood to the brain and surrounding structures in reptiles, birds and mammals, including huma ...

. * In 1978, he published the first observations of carotid plaque regression. * In 1980 he described the

Fistula In anatomy, a fistula (: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other h ...

Flow Ratio (French 'RDF') to assess the flow of

arteriovenous fistula An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arteri ...

s, especially in

renal dialysis Kidney dialysis is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally. Along with kidney transplantation, it is a type of renal replacement therapy. ...

. * In 1981, he invented an

interface Interface or interfacing may refer to: Academic journals * ''Interface'' (journal), by the Electrochemical Society * '' Interface, Journal of Applied Linguistics'', now merged with ''ITL International Journal of Applied Linguistics'' * '' Inter ...

process which allows for the first time the visualization of supra-aortic arteries by B-Mode echography. A Doppler method for exploring the compensatory ways of the cerebro-cervical

vasculature In vertebrates, the circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the body. It includes the cardiovascular system, or vascular system, that consists of the heart an ...

was published the same year. * In 1986, he published the first book of vascular ultrasound imaging ''Précis d'échotomographie vasculaire'' translated into Italian: « Compendio di ecotomografia vascolare » * In 1988, he published the book ''La cure Conservatrice et Hémodynamique de l'Insuffisance Veineuse en Ambulatoire: CHIVA'' also translated into English and Italian, where he offers a new approach to the

physiology Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...

of deep and superficial venous circulation, introducing new concepts such as « Dynamic

hydrostatic pressure Hydrostatics is the branch of fluid mechanics that studies fluids at hydrostatic equilibrium and "the pressure in a fluid or exerted by a fluid on an immersed body". The word "hydrostatics" is sometimes used to refer specifically to water and o ...

fractioning », the veno- venous shunts and vicarious evolution of varices. According to this theory, varicose veins are not, as well as edema and ulcers, the cause of the venous insufficiency, but the result of

venous valves Veins () are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal c ...

incompetence instead and/or obstacles to the flow. Furthermore, destroying varices in impeding the natural

drainage Drainage is the natural or artificial removal of a surface's water and sub-surface water from an area with excess water. The internal drainage of most agricultural soils can prevent severe waterlogging (anaerobic conditions that harm root gro ...

of the

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...

, would be responsible for

relapse In internal medicine, relapse or recidivism is a recurrence of a past (typically medical) condition. For example, multiple sclerosis and malaria often exhibit peaks of activity and sometimes very long periods of dormancy, followed by relapse or r ...

s by a compensation effect (vicarious shunts). The CHIVA method removes the overload flow and pressure, resulting in ulcer healing and returning the normal caliber of the veins, including varicose veins. It merely consists in the accurate splitting of the gravitational

of the venous column and in the disconnection of closed shunts (depending on the particular configuration of each patient). From 1 to 5 divisions/

ligatures Ligature may refer to: Language * Ligature (writing), a combination of two or more letters into a single symbol (typography and calligraphy) * Ligature (grammar), a morpheme that links two words Medicine * Ligature (medicine), a piece of suture us ...

are performed under

local anesthetics A local anesthetic (LA) is a medication that causes absence of all sense, sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sen ...

and without hospitalization (

ambulatory The ambulatory ( 'walking place') is the covered passage around a cloister or the processional way around the east end of a cathedral or large church and behind the high altar. The first ambulatory was in France in the 11th century but by the 13t ...

). In addition, the saphenous veins are saved, a considerable advantage since these veins are the best material for by-passing the peripheral arteries, and completing

Coronary artery bypass surgery Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest ...

, more and more necessary for the aging population. Several

randomized controlled trials A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical ...

and a

Cochrane Library The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of systema ...

review have demonstrated CHIVA superiority in certain specific anatomical situations to conventional removal (stripping) of the saphenous vein. The CHIVA technique as a treatment of venous insufficiency is now accepted as the standard of care in those situations where it applies.
The CHIVA technique (Guidelines)
an
Results with Chiva (Guidelines)
. * In 1997, he describes the dynamic index of

venous reflux Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. Although usually just a cosmetic ailment, in some cases they cause fatigue, pain, itching, and nighttime leg cramps. These ve ...

(DRI), the Paranà Maneuver and the diagnosis of the plantar vein

by Duplex Ultrasound. * In 2010, he published the book ''Principles of venous hemodynamics'' detailing hemodynamic concepts of the venous insufficiency and their diagnostic and therapeutic consequences.C.Franceschi, P.Zamboni ''Principles of Venous Hemodynamics''. Novapublishers.com.

New York City New York, often called New York City (NYC), is the most populous city in the United States, located at the southern tip of New York State on one of the world's largest natural harbors. The city comprises five boroughs, each coextensive w ...

, 2010 *

References

{{DEFAULTSORT:Franceschi, Claude 1942 births Living people Angiology French neurologists History of medical ultrasonography