The Prevalence of Chronic Cerebrospinal Venous Insufficiency in Meniere Disease: 24-Month Follow-up after Angioplasty

Bruno, Aldo; Napolitano, Mariasanta; Califano, Luigi; Attanasio, Giuseppe; Giugliano, Vincenzo; Cavazzuti, Pier Paolo; Viccaro, Marika; Masci, Eleonora; Mastrangelo, Diego; Salafia, Francesca; Mazzone, Salvatore; Bernardo, B; Cagnoni, Laura; Filipo, Roberto; Vincentis, M. De; Greco, Antonio

doi:10.1016/j.jvir.2016.10.019

Cited by 34 publications

(34 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,3 I had no major adverse events in all patients and only minor adverse events in 5 patients treated with conservative therapy. 3 Therefore, I can affirm that PTA of the internal jugular veins and azygos vein is sure, and the risk of adverse events is low.…”

mentioning

confidence: 90%

“…There were no significant differences in the development of new MRIdetectable lesions between the venoplasty and sham groups 2 ; however, when the venoplasty group was divided into those with improved blood flow and those with no improved blood flow, the data showed that there were significantly fewer new lesions (p < 0.07 at 6 months; p < 0.05 at 12 months) in the venoplasty subgroup with improved venous flow. 3 Are the greater SDs seen in figure 2 of the Traboulsee et al 1 article due to better outcomes in a small subset of the venoplasty group with improved blood flow?…”

mentioning

confidence: 98%

See 1 more Smart Citation

Risks and benefits of clopidogrel–aspirin in minor stroke or TIA

2019

Neurology

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 90%

mentioning

confidence: 98%

Risks and benefits of clopidogrel–aspirin in minor stroke or TIA

2019

Neurology

View full text Add to dashboard Cite

show abstract

“…Based upon both the anatomy of venous inner ear drainage, an excess of endolymphatic fluids could be secondary to a chronic reduced or altered venous drainage of the anterior and posterior vestibular veins, and/or of the cochlear veins into the venous cerebrospinal system . Data obtained from recent studies seem to support the possible relationship between CCSVI and MD …”

Section: Introductionmentioning

confidence: 99%

Chronic cerebrospinal venous insufficiency and menière's disease: Interventional versus medical therapy

Attanasio

Califano

Bruno³

et al. 2019

The Laryngoscope

Self Cite

View full text Add to dashboard Cite

Objectives/Hypothesis To evaluate the incidence of chronic cerebrospinal venous insufficiency in Menière's disease patients and the effect of bilateral percutaneous transluminal angioplasty of the jugular/azygos veins compared to medical therapy. Study Design Prospective case–control study. Methods Five hundred fourteen subjects were included in the study, 412 affected by definite Menière's disease, and 102 healthy controls. All patients underwent audiovestibular and vascular examination. Patients with Menière's disease and concomitant cerebrospinal venous insufficiency were divided in two subgroups: patients who underwent vascular intervention with bilateral percutaneous transluminal angioplasty (PTA) of the jugular/azygos veins and patients treated with medical therapy. Results Chronic cerebrospinal venous insufficiency was diagnosed in 330/412 (80.1%) Menière's disease patients and in 12/102 healthy individuals (11.8%) (P < .001). In the two chronic cerebrospinal venous insufficiency subgroups, a significant difference in Dizziness Handicap Inventory scores was found between patients in the PTA group compared to patients treated with medical therapy (31 ± 8.6 vs. 48.1 ± 14.4; P < .001); no significant differences were found for the Tinnitus Handicap Inventory scores (50.8 ± 16.58 vs. 49.6 ± 17.5; P = .23). Subjective evaluation of aural fullness was significantly better in patients in the PTA group (P = .003) as well as pure‐tone average, which was significantly different between groups (49.8 ± 16.5 dB in the PTA group vs. 55.8 ± 13 in the medical therapy group; P = .035). Conclusions The results of the present study confirm the close relationship between vascular disorders and Menière's disease. The encouraging responses to vascular interventional therapy on Meniére's disease symptoms suggest that this may be a promising path for interpretation and treatment of this complex disease. Level of Evidence 2b Laryngoscope, 130: 2040–2046, 2020

show abstract

“…Chronic cerebrospinal venous insufficiency (CCSVI), described as a combination of extracranial venous structural and flow anomalies, had been proposed as contributing to the pathogenesis and disabling symptoms 2 in MS, and subsequently in other conditions including Alzheimer disease, 3 Parkinson disease, 4 and Ménière disease. 5 It had been postulated that impaired venous drainage would cause stasis leading to perivenular iron deposition triggering inflammation. This pathogenic hypothesis remains poorly supported, and venous narrowing has been found as frequently in healthy volunteers as in patients with MS. 6 Multiple uncontrolled, unblinded studies and case series suggested that venous dilation with or without intravascular stenting could improve symptoms and modify the disease course in MS 2 , 7 – 15 and Ménière disease.…”

mentioning

confidence: 99%

“…This pathogenic hypothesis remains poorly supported, and venous narrowing has been found as frequently in healthy volunteers as in patients with MS. 6 Multiple uncontrolled, unblinded studies and case series suggested that venous dilation with or without intravascular stenting could improve symptoms and modify the disease course in MS 2 , 7 – 15 and Ménière disease. 5 These procedures were promoted through social media and were readily available through medical tourism 16 despite warnings by regulatory bodies including the US Food and Drug Administration about significant complications. 17 …”

mentioning

confidence: 99%

Safety and efficacy of venoplasty in MS

et al. 2018

View full text Add to dashboard Cite

ObjectiveTo determine the safety and efficacy of balloon vs sham venoplasty of narrowing of the extracranial jugular and azygos veins in multiple sclerosis (MS).MethodsPatients with relapsing or progressive MS were screened using clinical and ultrasound criteria. After confirmation of >50% narrowing by venography, participants were randomized 1:1 to receive balloon or sham venoplasty of all stenoses and were followed for 48 weeks. Participants and research staff were blinded to intervention allocation. The primary safety outcome was the number of adverse events (AEs) during 48 weeks. The primary efficacy outcome was the change from baseline to week 48 in the patient-reported outcome MS Quality of Life–54 (MSQOL-54) questionnaire. Standardized clinical and MRI outcomes were also evaluated.ResultsOne hundred four participants were randomized (55 sham; 49 venoplasty) and 103 completed 48 weeks of follow-up. Twenty-three sham and 21 venoplasty participants reported at least 1 AE; one sham (2%) and 5 (10%) venoplasty participants had a serious AE. The mean improvement in MSQOL-54 physical score was +1.3 (sham) and +1.4 (venoplasty) (p = 0.95); MSQOL-54 mental score was +1.2 (sham) and −0.8 (venoplasty) (p = 0.55).ConclusionsOur data do not support the continued use of venoplasty of extracranial jugular and/or azygous venous narrowing to improve patient-reported outcomes, chronic MS symptoms, or the disease course of MS.ClinicalTrials.gov identifierNCT01864941.Classification of evidenceThis study provides Class I evidence that for patients with MS, balloon venoplasty of extracranial jugular and azygous veins is not beneficial in improving patient-reported, standardized clinical, or MRI outcomes.

show abstract

The Prevalence of Chronic Cerebrospinal Venous Insufficiency in Meniere Disease: 24-Month Follow-up after Angioplasty

Cited by 34 publications

References 20 publications

Risks and benefits of clopidogrel–aspirin in minor stroke or TIA

Risks and benefits of clopidogrel–aspirin in minor stroke or TIA

Chronic cerebrospinal venous insufficiency and menière's disease: Interventional versus medical therapy

Safety and efficacy of venoplasty in MS

Contact Info

Product

Resources

About