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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2012 December;171(6):755-65
Endovascular diagnostics and therapy of chronic cerebrospinal venous insufficiency
Petrov I., Grozdinski L., Martinov I., Iliev N., Kaninski G.
Clinic of Cardiology and Angiology, Tokuda Hospital, Sofia, Bulgaria
AIM: To determine the frequency, nature and localization of venous stenosis in jugular and azygos vein among patients with chronic cerebrospinal venous insufficiency (CCSVI) and Multiple Sclerosis (MS). To perform endovascular therapy and register its clinical effects.
METHODS: Using ultrasound, CCSVI was observed in 123 MS patients. Among the CCSVI group, venography of internal jugular vein (IJV) and azygos was performed. The venous stenoses were recorded. Endovascular treatment was performed with balloon dilation or stent implantation. The early and late post-procedural effects were evaluated.
RESULTS: During the phlebography, stenoses in IJV and/or the azygos vein among all the CCSVI patients were observed. Among the 123 patients 87% stenoses were registered. In the azygus vein, 67.4% were observed. A total of 161 IJV dilations and 77 dilations of the azygos vein were performed. A total of 55 stent implantations in the IJV and 6 in the azygos vein were performed. Thus, 299 endovascular procedures were conducted in 81% of all the present cerebrospinal veins. The post procedural Doppler examinations registered an increase of the IJV diameter and an increase of the venous flow. Early clinical improvements were registered in 87% of the patients treated. Three months after the treatment, clinical improvement was established among 63%. The average EDSS score among the patient group had improved from 5.3 to 4.7.
CONCLUSION: Using phlebography stenosises were found in approximately 90% of the veins in patients with CCSVI. Early and late clinical improvements were recorded after endovascular therapy.