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Society of Interventional Radiology (SIR) Abstract for 2012
Intravascular ultrasound: key role in diagnosis of azygous arch causes of CCSVI
Sclafani, Salvatore J.A.
1. American Access Care, Brooklyn, NY, United States.
2. Radiology, SUNY Downstate Medical Center, Brooklyn, NY, United States.
Original Scientific Research - Poster
Venous Interventions: Other
CCSVI, azygous vein, multiple sclerosis
The purpose of this study was to determine how often IVUS facilitates detection of AZV arch stenoses in patients with CCSVI.
The azygous (AZV) vein is an important component of the venous drainage of the cerebrospinal vasculature. It is the primary venous outflow for the spinal cord of the thoracic and lumbar spine and forms an outlet for cerebral venous drainage when there are outflow obstructions of the intemal jugular veins (IJV) as seen in chronic cerebrospinal venous insufficiency (CCSVI). Detection of venous stenoses of the is challenging because of artefacts due to mediastinal motion. lntravascular ultrasound does not suffer from this problem.
Materials and Methods
Thirty random patients with CCSVI detected by Neck and Transcranial Doppler ultrasound whose endovascular procedures detected arch lesions were reviewed. In all patients IVUS followed venography. We retrospectively reviewed venography looking for stenosis, reflux and webs and IVUS looking for immobile valves, webs. or septum.
IVUS was abnormal in each patient. immobile valves (30 patients), webs (1 patient) and septums (2 patients) were discovered. The most common finding on venography was reflux (19 patients) Stenoses were identified in 8 patients. Venography was considered normal, even in retrospect, in 8 patients.
Intraluminal lesions may be difficult to identify on venography. Findings are often nonspecific reflux of contrast media that does not allow precise angioplasty. KVUS appears to be the gold standard for the diagnosis of azygous causes of CCSVI.