Venous Hemodynamic Insufficiency Severity Score variation after endovascular treatment of chronic cerebrospinal venous insufficiency

Scalise, Filippo; Novelli, Eugenio; Farina, Mário; Barbato, Luciano; Spagnolo, Salvatore

doi:10.1177/0268355514524193

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Scalise et al showed in a group of 45 MS patients, who underwent jugular veins venoplasty, a statistically significant improvement in the venous hemodynamics and venous hemodynamic severity score (VHISS) [26], which, as in our study, demonstrated the impact of angioplasty procedures on the changes in hemodynamics within the cerebral flow. The result of the work carried out by Sternberg et al may be an indirect evidence of the impact of treatments on the jugular venous hemodynamics.…”

Section: Discussionsupporting

confidence: 85%

The Hemodynamics of Blood Flow through the Internal Jugular Veins after CCSVI Endovascular Treatment and its Impact on the Quality of Life in Patients with Chronic Cerebrospinal Venous Insufficiency

Kostecki¹,

Zaniewski²

2016

Brain Disord Ther

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Objectives: The aim of the study was to compare pre-and post-operative blood flow through the internal jugular veins (IJVs) in patients with multiple sclerosis and chronic cerebrospinal venous insufficiency, who were subjected to endovascular treatment. The results were correlated with respect to changes in the quality of life. Methods: 144 MS patients underwent endovascular treatment of the IJVs. The blood flow through the IJVs was assessed by the means of the Doppler ultrasonography. The clinical neurological evaluation was based on the various diagnostic tools (scales). The assessment of the blood flow through the IJVs and an evaluation of the quality of life changes were performed before surgery, and at 1, 3 and 6 months after surgery. Results: A statistically significant increase in the blood flow through the IJVs was identified on both sides during all three postoperative controls. The relationship between the IJV flow changes and the parameters related to the quality of life assessment, a statistically significant positive correlation between the flow improvement in the right IJV and Multiple Sclerosis Impact Scale, as well as Fatigue Severity Scale scores, were found. For the remaining evaluated scales (Expanded Disability Status Scale, Heat Intolerance Scale and Epworth Sleepiness Scale), as well for the flow in the left IJV, there were no statistically significant correlations confirmed. Conclusion: Despite a significant improvement in the blood flow through the IJVs after endovascular interventions on the IJVs in CCSVI patients, it has not demonstrated that hemodynamic changes improve the quality of life in MS patients.

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Section: Discussionsupporting

confidence: 85%

The Hemodynamics of Blood Flow through the Internal Jugular Veins after CCSVI Endovascular Treatment and its Impact on the Quality of Life in Patients with Chronic Cerebrospinal Venous Insufficiency

Kostecki¹,

Zaniewski²

2016

Brain Disord Ther

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“…Intraluminal defects are regarded as main etiologies, causing a significant delay of jugular flow. Percutaneous transluminal balloon angioplasty and stenting have been demonstrated to be feasible and safe with low procedure‐related morbidity and mortality among patients with CCSVI . Moreover, fixing the flow in the IJV via endophlebectomy of the jugular valve or septum together with patch angioplasty using the autologous great saphenous vein seems to robustly ameliorate cerebral perfusion .…”

Section: Treatmentmentioning

confidence: 99%

Understanding jugular venous outflow disturbance

Zhou

Ding

et al. 2018

CNS Neurosci Ther

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Extracranial venous abnormalities, especially jugular venous outflow disturbance, were originally viewed as nonpathological phenomena due to a lack of realization and exploration of their feature and clinical significance. The etiology and pathogenesis are still unclear, whereas a couple of causal factors have been conjectured. The clinical presentation of this condition is highly variable, ranging from insidious to symptomatic, such as headaches, dizziness, pulsatile tinnitus, visual impairment, sleep disturbance, and neck discomfort or pain. Standard diagnostic criteria are not available, and current diagnosis largely depends on a combinatory use of imaging modalities. Although few researches have been conducted to gain evidence-based therapeutic approach, several recent advances indicate that intravenous angioplasty in combination with stenting implantation may be a safe and efficient way to restore normal blood circulation, alleviate the discomfort symptoms, and enhance patients' quality of life. In addition, surgical removal of structures that constrain the internal jugular vein may serve as an alternative or adjunctive management when endovascular intervention is not feasible. Notably, discussion on every aspect of this newly recognized disease entity is in the infant stage and efforts with more rigorous designed, randomized controlled studies in attempt to identify the pathophysiology, diagnostic criteria, and effective approaches to its treatment will provide a profound insight into this issue.

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“…It may be that similar structures to those observed in the FM case (large thrombotic-like strands) may also be present in MS patients. However, endovascular attempts to remove these blockages have had varying degrees of success in reversing symptoms of MS [134,[138][139][140][141][142][143][144][145][146][147][148][149][150][151][152][153][154]. The formation of streamers by bacterial biofilms in a cardiovascular stent model has been shown to produce a dramatic reduction in flow rate similar to that seen in CCS-VI [155].…”

Section: Discussionmentioning

confidence: 99%

Putative biofilm-forming organisms in the human vasculature: expanded and review of the literature

Fry¹,

Ellis²,

Shabilla³

et al. 2014

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Objectives: New technologies, particularly in the field of clinical metagenomics, have opened up new avenues to explore microbial involvement in illnesses where disease initiation is poorly understood. Here we present a series of six patients suffering from diseases with potential microbial involvement: systemic lupus erythematosus, chronic fatigue syndrome, fibromyalgia, multiple sclerosis, amyotrophic lateral sclerosis, and arteriosclerosis. Material and methods: Peripheral blood (first five cases) and suction debris from carotid percutaneous angioplasty (arteriosclerosis) were refrigerated and transported to the site of analysis. DNA was extracted using the standard QIAamp DNA Blood Mini and Protozoal Extraction kits. Bacterial-specific DNA sequences were amplified and subsequently barcoded for DNA sequencing with 16S rRNA-directed primers flanking the variable regions 1 and 2 and variable regions 4 and 5, respectively. Protozoal-specific DNA sequences were amplified and subsequently barcoded for DNA sequencing using low stringency conditions and primers directed to variable regions in the 18S rRNA gene. Results: We found previously unreported mixed bacterial and protozoal biofilm communities in all samples. In all six disease types we revealed protozoa, being close relatives to known aquatic-based protozoa, such as: Oblongichytrium, Chrysocapsa vernalis, Ochromonas, and Perkinsus qugwadi. In a blood sample from the patient with lupus erythematosus DNA stains and culture studies revealed an unknown protozoan exhibiting profound biofilm-forming capability: candidatus Protomyxzoa rheumatica. Conclusions: Discovery of these potentially pathogenic protozoa in human blood may be of great clinical relevance. However, our preliminary results should be confirmed by independent researchers, and the role of biofilm-forming protozoa in human disease should be elucidated.

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Venous Hemodynamic Insufficiency Severity Score variation after endovascular treatment of chronic cerebrospinal venous insufficiency

Abstract: CCSVI endovascular treatment can induce an improvement in VH parameters and the VHISS. The neurological disability score (EDSS) also improved after PVA; however, there was no correlation to the VHISS variation after PVA, MS type and duration.

Cited by 4 publications

References 12 publications

The Hemodynamics of Blood Flow through the Internal Jugular Veins after CCSVI Endovascular Treatment and its Impact on the Quality of Life in Patients with Chronic Cerebrospinal Venous Insufficiency

The Hemodynamics of Blood Flow through the Internal Jugular Veins after CCSVI Endovascular Treatment and its Impact on the Quality of Life in Patients with Chronic Cerebrospinal Venous Insufficiency

Understanding jugular venous outflow disturbance

Putative biofilm-forming organisms in the human vasculature: expanded and review of the literature

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