Objectives: Duplex sonography has been proposed as a diagnostic modality for detection of chronic cerebrovascular venous insufficiency, a recently proposed hypothesis of multiple sclerosis (MS) pathogenesis. We reviewed potential challenges of duplex sonography for diagnosis of chronic cerebrovascular venous insufficiency and used interim pooled data from a study aimed to apply cerebrovascular venous insufficiency criteria to a group of patients with MS and control patients without MS.
Methods: Duplex sonography for chronic cerebrovascular venous insufficiency was performed in patients with MS and controls. Extracranial and deep cerebral veins were studied by using a published chronic cerebrovascular venous insufficiency protocol and criteria. Comparative imaging was performed to explore how physiologic factors and imaging techniques could affect key parameters. The effects of varying definitions on fulfilling chronic cerebrovascular venous insufficiency diagnostic criteria were also explored.
Results: Forty-two patients were enrolled. Twenty-five (60%) had a reduction in internal jugular vein cross-sectional area by 50% or more, cross-sectional area of 0.3 cm(2) or less, and/or a B-mode abnormality. No patients had reflux longer than 0.88 seconds in both sitting and supine positions, the presence of duplex sonographic reflux on transcranial Doppler imaging, or a larger internal jugular vein cross-sectional area in the sitting versus supine position. Fourteen patients (33.3%) had either a flap or septum, and 1 had a web. Collateral veins to the vertebral veins were identified in 14 of 42 patients (33.3%). The use of transcranial Doppler imaging versus quality Doppler profiles resulted in fewer patients meeting criteria for chronic cerebrovascular venous insufficiency.
Conclusions: There are several important variables, including physiologic, technical, and criterion definitions, in the application of sonographic assessment of chronic cerebrovascular venous insufficiency that may affect diagnostic accuracy.
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http://dx.doi.org/10.7863/ultra.34.6.1097 | DOI Listing |
Int J Surg
January 2025
Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Microsurgery demands an intensive period of skill acquisition due to its inherent complexity. The development and implementation of innovative training methods are essential for enhancing microsurgical outcomes. This study aimed to evaluate the impact of a simulation training program on the clinical results of fingertip replantation surgeries.
View Article and Find Full Text PDFPurpose: To explore the anatomical features of left iliac vein (LIV) in non-thrombotic venous leg ulcers (VLUs) and to identify the impact of these anatomical features on VLUs based on computed tomography venography (CTV).
Methods: This is a retrospective, single-center study of a database (2021-2023) of 431 patients with non-thrombotic chronic venous insufficiency. According to CEAP clinical (C) classifications, cases of C6 and C2 were included for analysis as case and control groups.
Radiol Case Rep
March 2025
Department of Radiology, Rafidia Surgical Hospital, Nablus, Palestine.
May-Thurner syndrome (MTS), iliac vein compression syndrome, also called Cockett syndrome, is a vascular disease caused by the compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) against the lumbar vertebrae. This anatomical defect can lead to venous stasis especially in the left lower limb, and this increases the risk of deep venous thrombosis (DVT). Because routine screening is not standard practice, MTS frequently remains asymptomatic, and its prevalence is probably underestimated.
View Article and Find Full Text PDFJAAD Case Rep
February 2025
Department of Dermatology, Norfolk and Norwich University Hospitals NHS Foundation trust, Norwich, United Kingdom.
Port J Card Thorac Vasc Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture.
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