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A Journal on Phlebology
Acta Phlebologica 2014 December;15(3):107-15
Assessment of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis by a Morphological-Hemodynamic-Map software
Mandolesi S. 1, Niglio T. 2, D’Alessandro A. 3, Mandolesi D. 1, Agati L. 1, D’Alessandro A. 4, Ciccone M. M. 5, Zito A. P. 5, Orsini A. 6, Manconi E. 7, Fedele F. 1
1 Department of Cardio‑vascular and Respiratory Sciences, Nephrology and Geriatric, “Sapienza” University, Rome, Italy;
2 Istituto Superiore di Sanità, Rome, Italy;
3 Department of Angiology, T. Masselli‑Mascia Hospital San Severo, Naples, Italy;
4 Faculty of Medicine Catholic University, Our Lady of Good Counsel, Tirana, Albanian;
5 Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy;
6 Department of Chirurgia Vascolare, Gioia Hospital Sora, Frosinone, Italy;
7 Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy
AIM: The aim of the present study was to determine a Echo-Color-Doppler (ECD) data analysis algorithm for patients with multiple sclerosis (MS) affected by chronic cerebrospinal venous insufficiency (CCSVI) by using a morphological-hemodynamic-map (MEM-net). The CCSVI is a new nosological vascular pattern that has been recently founded also in MS patients.
METHODS: We investigated 552 MS patients (mean age: 43±10 years) by Echo-Color-Doppler (ECD, MyLab Vinco System, Esaote), out of which 333 females (60%) and 219 males (40%). The identification of CCSVI by ECD examination was obtained following Zamboni’s criteria. The ECD data were analysed by MEM-net software (www.mem-net.it), which made possible an on-line diagnosis of positive (83%) or negative (17%) CCSVI patients.
RESULTS: We classified CCSVI in three different types by identifying a new hemodynamic parameter the “venous compression”. Type-1 with intravenous block (17%), type-2 with extravenous compression (4%) and type-3 with both conditions (79%).
CONCLUSION: The results provide the hemodynamic basis for a new CCSVI classification, which may lead to a better optimization of individual treatment.