A personal case-report of CCSVI.
Male, 40 years-old patient with chronic-progressive multiple sclerosis.
MS diagnosis in 2002.
The examinations were conducted in two different centers.
Neck Ultrasound (June 11, 2010)
EchoDoppler study of venous vessels of the neck. Survey carried out in the upright and supine positions. Trans-cranial evaluation of deep venous flow.
Left evident stenosis of intermediate section of the internal jugular vein and presence of parietal membrane with findings confirmed in the supine and upright positions.
The right internal jugular vein shows stenotic change in the intermediate section. The spinal flow is physiologically accentuated bilaterally in the upright position with decrease in inspiratory. Not sampled the flow in the supine position.
The assessment at the level of trans-cranial venous collector of Galen shows signs of reflux in both decubitus.
The findings meet the CCSVI criteria.
Percutaneous Transluminal Angioplasty (November 9, 2010)
Run left femoral access with double venipuncture (2 introducers 8F). The injection of contrast into the left common femoral vein shows slight slowdown in the flow of contrast into the ipsilateral iliac vein with opacification of the ipsilateral internal iliac vein and sacral venous circulation.
The ilio-lumbar circle appears less obvious gauge with anarchist circles in the last lumbar vertebrae.
Then proceeds to study the internal jugular vein bilaterally, the vertebral circulation and azygos vein.
Presence of slow flow in the left internal jugular vein at the ostium (90%). We proceed to balloon dilation of vascular malformation ostium (kissing balloon 10 x 20 and 12 x 20 mm at a pressure of 26 atm) with good resolution of the same at the end.
A right internal jugular vein shows narrowings of approximately 85% in the ostium in the absence of further changes along the course of the vessel. Proceed to the PTA lesion at the ostium (kissing balloon technique - see above) with good final angiographic result at the end of the maneuver and restore flow to the right innominate vein.
Azygos vein with moderate slowing of the flow in the presence of valve malformation limiting the flow. Distally there is a concentric narrowing of the vessel treated at previous PTA elsewhere. Run angioplasty in the first leg of the vein using high pressure balloon 12 x 20 mm with clear improvement of the flow in the superior vena cava and complete disappearance of opacification of the malformation of the valve leaflets of malformation paraostiale to final inspection.
There was no other dependents of the distal azygos vein and hemiazygos.VIDEO