Efficiency And Safety Of Endovascular Treatment For Chronic Cerebrospinal Venous Insufficiency

Objective:In this study,the efficacy and safety of intracavitary treatment of chronic cerebrovascular venous insufficiency(CCSVI)were analyzed retrospectively.Methods: January 2015 to December 2016,44 consecutive patients were diagnosed CCSVI by catheter venography and underwent endovascular treatment.The mean ageand mean disease duration were 54(46.5,62.5)years and 56.04±73.83 months.Exclusion criteria include simultaneous radiotherapy for the neck,open surgical treatment,and neck / mediastinal tumors,severe heart or lung disease.Define level 0 for normal venous return.Class 1-4 and accompanied by symptoms with treatment indications.All subjects were selected percutaneous transluminal angioplasty(PTA)or PTA + stent implantation according to intraoperative conditions.The safety of endovascular treatment was evaluated by the operation success rate and postoperative complications.Technical success rate,restenosis,and improvement of clinical symptoms(by dizziness handicap inventory(DHI))were used to evaluate the effectiveness of endovascular surgery.All patients undergoing endovascular treatment were required continuous anticoagulation or antiplatelet therapy as prescribed.CTV or color Doppler ultrasonography was performed to observe the patency of the vessel,and pations need to complete the questionnaire after 3 months of surgery.Results : A total of 44 patients with CCSVI underwent endovascular treatment,including 38 patients(38/44,86.4%)underwent PTA alone and 6 patients(6/44,13.6%)underwent PTA + stenting.Stents were all placed in the left internal jugular vein.Surgery success was defined as the ability to place the angiographic catheter at the proximal end of the target vessel and to perform angiography,in addition successfully expand the balloon and release the stent.The surgery success rate was 100%.Preoperative / postoperative reflux grading show in 73 lesion vascular: grade0:0/40(54.8%),grade1:11(15.1%)/30(41.1%),grade 2:17(23.3%)/3(4.1%),grade 3:39(53.4%)/0,grade 4:6(8.2%)/0?The mean score of DHI decreased from preoperative 31.14 ± 8.69 to postoperative 12.23 ± 9.52(P = 0.00).3 months follow-up,no major complications were reported(such as death,bleeding,cerebral hemorrhage,thrombosis).4 pations(4/44,9.1%)with simple PTA suffered postoperative restenosis.4 patients(4/44,9.1%)occurred contrast agent-related gastrointestinal adverse reactions.Conclusions: Endovascular treatment of CCSVI is safe and effective in the short term.The presence of simple PTA posterior restenosis in this article suggests whether we should relax the stent implants appropriately.It still needs a large sample of randomized controlled trials to further validate.