Distúrbios cerebrais e terapia

Abstrato

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

Jacek Kostecki, Maciej Zaniewski, Tomasz Urbanek, Tomasz Korzeniowski, Damian Ziaja and Mariola Sznapka

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.