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

Background

After Shigeo Satomura who detected for the first time the blood flow with a Doppler Ultrasound machine,

Gene Strandness Donald Eugene Strandness (September 22, 1928 – January 7, 2002) was an American physician, university professor, and research scientist. Dr. Strandness, known as Gene, was influential in the development of Doppler ultrasound as a diagnostic ...

measured the blood pressure at the ankle (1967), Léandre Pourcelot proposed the Arterial resistivity index (1974), and Gosling the

Pulsatility index 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 ...

(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 with arterial and venous hemodynamics. After studying the correlations between the Doppler ultrasound, radiological and surgical data, he laid down the methodological and

semiotic Semiotics (also called semiotic studies) is the systematic study of sign processes ( semiosis) and meaning making. Semiosis is any activity, conduct, or process that involves signs, where a sign is defined as anything that communicates something ...

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 A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in 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'' ...

quantification and a quality diagnostic. In particular, he worked on the criteria of arterial stenosis of limbs and carotids, Carotid pre- thrombosis, the Pressure-Perfusion Index (Franceschi Index), the Carotid Ratio and the exploration of the Circle of Willis. * In 1978, he published the first observations of carotid plaque regression. * In 1980 he described the Fistula Flow Ratio (French 'RDF') to assess the flow of arteriovenous fistulas, especially in

renal dialysis Kidney dialysis (from Greek , , 'dissolution'; from , , 'through', and , , 'loosening or splitting') is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions natura ...

. * In 1981, he invented an interface 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 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 of deep and superficial venous

circulation Circulation may refer to: Science and technology * Atmospheric circulation, the large-scale movement of air * Circulation (physics), the path integral of the fluid velocity around a closed curve in a fluid flow field * Circulatory system, a bio ...

, introducing new concepts such as « Dynamic hydrostatic pressure 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 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 the pulmonary and umbilical veins, both of which carry oxygenated b ...

incompetence instead and/or obstacles to the flow. Furthermore, destroying varices in impeding the natural drainage of the skin, would be responsible for relapses 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 hydrostatic pressure 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: * Ligature (medicine), a piece of suture used to shut off a blood vessel or other anatomical structure ** Ligature (orthodontic), used in dentistry * Ligature (music), an element of musical notation used especially in the me ...

are performed under

local anesthetics A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general an ...

and without hospitalization ( ambulatory). In addition, the saphenous veins are saved, a considerable advantage since these veins are the best material for by-passing the

peripheral arteries The peripheral vascular system is the part of the circulatory system that consists of the veins and arteries not in the chest or abdomen (i.e. in the arms, hands, legs and feet). The peripheral arteries supply oxygenated blood to the body, and ...

, 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 pai ...

, 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 te ...

and a Cochrane Library 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. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indi ...

(DRI), the Paranà Maneuver and the diagnosis of the plantar vein thrombosis 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, 2010 *

References

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