Search results for "insufficiency"
showing 10 items of 506 documents
An overview of randomized controlled trials on endovascular treatment for chronic cerebrospinal venous insufficiency in multiple sclerosis patients
2020
AbstractAbout ten years ago it was hoped that venous angioplasty for abnormal veins, primarily the internal jugular veins, will be a much awaited treatment for multiple sclerosis. Yet, a majority of randomized clinical trials on endovascular treatment for chronic cerebrospinal venous insufficiency did not reveal clinical efficacy of these procedures in multiple sclerosis patients. Still, a detailed analysis of these trials suggests that they were poorly designed, underpowered and endovascular techniques used were often far from being optimal. Nonetheless, even considering weak points of these trials, it can be concluded that venous angioplasty should not be used as a routine treatment modal…
Potential Involvement of Impaired Venous Outflow from the Brain in Neurodegeneration: Lessons Learned from the Research on Chronic Cerebrospinal Veno…
2019
About 10 years ago, the so-called chronic cerebrospinal venous insufficiency syndrome was discovered. This clinical entity, which is associated with extracranial venous abnormalities that impair venous outflow from the brain, was initially found exclusively in multiple sclerosis patients. Currently, we know that such venous lesions can also be revealed in other neurological pathologies, including Alzheimer’s and Parkinson’s diseases. Although direct causative role of chronic cerebrospinal venous insufficiency in these neurological diseases still remains elusive, in this paper, we suggest that perhaps an abnormal venous drainage of the brain affects functioning of the glymphatic system, whi…
A topodiagnostic investigation on body lateropulsion in medullary infarcts.
2005
Body lateropulsion may occur without signs of vestibular dysfunction and vestibular nucleus involvement. The authors examined 10 such patients with three-dimensional brainstem mapping. Body lateropulsion without limb ataxia reflected an impairment of vestibulospinal postural control caused by a lesion of the descending lateral vestibulospinal tract, whereas body lateropulsion with limb ataxia was probably the consequence of impaired or absent proprioceptive information caused by a lesion of the ascending dorsal spino-cerebellar tract.
Outcomes of transcatheter tricuspid valve intervention by right ventricular function: a multicentre propensity-matched analysis
2021
BACKGROUND Tricuspid regurgitation (TR) has a poor prognosis and limited treatment options and is frequently accompanied by right ventricular (RV) dysfunction. Transcatheter tricuspid valve interventions (TTVI) to reduce TR have been shown to be safe and feasible with encouraging early results. Patient selection for TTVI remains challenging, with the role of right ventricular (RV) function being unknown. AIMS The aims of this study were 1) to investigate survival in a TTVI-treated patient population and a conservatively treated TR population, and 2) to evaluate the outcome of TTVI as compared to conservative treatment stratified according to the degree of RV function. METHODS We studied 684…
Determinants of elevated carbohydrate antigen 125 in patients with severe symptomatic aortic valve stenosis referred for transcatheter aortic valve i…
2018
Elevated carbohydrate antigen 125 (CA125) predicts adverse outcome after transcatheter aortic valve implantation (TAVI). While known underlying pathophysiological mechanisms of elevated CA125 include serosal effusions and inflammatory stimuli, clinical determinants associated with elevated CA125 in patients referred for TAVI remain unknown. Therefore, we investigated clinical, laboratory and echocardiographic determinants of elevated CA125 in patients with severe aortic valve stenosis referred for TAVI.This study includes 650 patients with severe aortic stenosis referred for TAVI. Baseline CA125 was determined by an immunoassay and dichotomized (elevated versus normal) based on the manufact…
Activation of the glymphatic system during sleep – is the cerebral venous outflow a missing piece of the puzzle?
2019
Until recently, mechanisms responsible for an activation of the glymphatic system of the brain, the system which is responsible for cleansing of this organ of waste products, were unclear. A recently published paper has finally shed some light on this problem. It has been demonstrated that there is a temporary decrease of the arterial cerebral blood flow during the deep phase of sleep, which is followed by an influx of the cerebrospinal fluid into the cranial cavity, and that this phenomenon is probably responsible for the activation of the glymphatic system. Although, of as yet, this issue has not been studied, it is likely that such a mechanism is not effective in the settings of disturbe…
Transcatheter indirect mitral annuloplasty induces annular and left atrial remodelling in secondary mitral regurgitation
2020
Abstract Aims Mitral annuloplasty using the Carillon Mitral Contour System (CMCS) reduces secondary mitral regurgitation (SMR) and leads to reverse left ventricular remodelling. The aim of this study was to evaluate the effect of the CMCS on the mitral valve annulus (MA) and left atrial volume (LAV). Methods and results We retrospectively evaluated the data of all patients treated with the CMCS at our centre. Using transthoracic echocardiography, MA diameters were assessed by measuring the anterolateral to posteromedial extend (ALPM) and the anterior to posterior (AP) dimensions, respectively. Also, LAV and left ventricular end‐diastolic volume (LVEDV) were assessed. Patients were examined …
Diagnostic accuracy of Doppler sonography and magnetic resonance venography for the assessmentv of impaired outflow from the internal jugular vein in…
2015
Objectives: This prospective study was aimed at evaluation of diagnostic value of Doppler sonography and magnetic resonance (MR) venography in the internal jugular vein territory. Material and methods: There were assessed 126 patients (252 internal jugular veins). The patients were initially diagnosed using Doppler sonography and MR venography, and then catheter venography of the veins was performed. For the purpose of this study catheter venography was regarded the reference test. We interpreted sonographic findings in the context of criteria proposed by Zamboni and criteria by International Society for Neurovascular Disease (ISNVD). We applied MR protocols aimed at flow assessment in the …
Multiple sclerosis, an unlikely cause of chronic cerebrospinal venous insufficiency: retrospective analysis of catheter venography.
2013
Objectives It is unknown if a relationship exists between multiple sclerosis and chronic cerebrospinal venous insufficiency and if this venous pathology is a causal factor for multiple sclerosis or is a product of a neurological disease. Even so, one should expect that if multiple sclerosis were the cause for venous lesions, then patients with an extended history of the disease would present with a more severe venous pathology. Design Retrospective analysis of catheter venography of the azygous and internal jugularveins, and duration of clinical history of the disease in multiple sclerosis patients. Setting Mono-profile specialist hospital. Participants 353 multiple sclerosis patients, with…
Minimally invasive techniques in the treatment of saphenous varicose veins.
2008
Lower extremity venous insufficiency is common and increases with age. In addition to classical symptoms, it may result in skin changes and venous ulcers. Chronic venous insufficiency has a great impact on patients' health-related quality of life and is associated with considerable health care costs. Surgical ligation Of the junction with or without stripping has been the standard of care in the treatment of insufficient great and small saphenous veins. However, the recurrence rates are relatively high and surgery may be associated with serious adverse events and considerable down time; it is also cosmetically Suboptimal. To improve efficacy, patients' health-related quality of life and tre…