Factors influencing the hemodynamic response to balloon angioplasty in the treatment of outflow anomalies of internal jugular veins

For those folks seeking a good research on Internal Jugular Vein Ballooning effect on IJV narrowing, this is by far, the only study I have found to be exhaustive in terms of comparing the types of jugular narrowing that benefits from ballooning and the ones that don’t. The finding is interesting. In short, If you are young and have transverse endoluminal defects (wide or cross-sectional/horizontal narrowing), you have better chance of narrowing being corrected by Percutaneous Transluminal Angioplasty ( PTA - meaning IJV Ballooning). But if you have hypoplastic IJV (narrowing by birth) or have longitudinal endoluminal defects (Vertical narrowing of IJV), your chances to have it corrected by ballooning are slim.

ABSTRACT
Objective: Percutaneous transluminal angioplasty (PTA) of the internal jugular veins (IJVs) has been proposed in recent
years to treat chronic cerebrovascular venous insufficiency, with discordant results. Moreover, very little is known about
the efficacy of PTA in restoring a normal cerebral venous outflow. The aim of this study was to investigate the anatomic
factors and patient characteristics that might influence the efficacy of PTA of the IJV.
Methods: There were 797 consecutive patients with venous outflow anomalies who underwent standardized, operatorindependent catheter venography and PTA of the IJVs. Before and after PTA, morphologic and hemodynamic anomalies
of the IJVs were documented. The primary end point of the study was to evaluate the morphologic factors influencing
the efficacy of angioplasty in improving IJV outflow.
Results: PTA resulted in an increased outflow through the IJVs in most patients. However, younger individuals with
transverse endoluminal defects and higher pre-PTA flows are more likely to respond well to PTA compared with those
who exhibit hypoplasia, stenosis, or longitudinal endoluminal defects.
Conclusions: This study identified the factors that influence and could predict the efficacy of PTA in the treatment of IJV
anomalies. (J Vasc Surg: Venous and Lym Dis 2017;5:777-88.)

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Study Link : JVSVL.pdf (1.9 MB)

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Thanks @KoolDude :+1:

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So most of us with Eagles would have the cross sectional kind of defect, right? I had the ballooning of veins up through to the jugulars as described for CCSVI. That’s how my venous Eagles was found; the doctor’s catheter could not get past the bony blockage at the styloid to C1.

I felt much improved in general after the procedure, which was said to treat symptoms of dysautonomia. It seemed to improve my circulation in general.

My family practice MD pointed out that balloon angioplasty of arteries is done all the time even though it is in fact potentially dangerous. Because veins are elastic, he thought the veins treatment would be a lot safer.

There was a lot of confusion surrounding the CCSVI discovery and treatment when it became available around 2011, in part because it helped many but not all people with the diagnosis of MS. And while most insurance covers these angioplasties for arteries, I guess the use for veins is still sort of new.

You do a lot of research! Thank you.

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One more thing that isn’t mentioned could be beneficial effects on the vagus nerve? The good effects on nerves was emphasized to me by the interventional radiologist, which would improve symptoms of dysautonomia.

Are you still planning to do the jugulars venoplasty in Canada, I hope?

Best wishes, it’s a process is what I’ve been advised.

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I am not planning because the C1 appears to be compressing my Jugular Vein so any endovascular procedure be it ballooning or stent won’t do much until the bone compression is removed. So I am seeking C1 atlas trimmer surgeon right now.

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@Violin - Did the angioplasty improve your dysautonomia then? If so, what percentage wise would you say? Thanks

Yes, guessing 75%?

(This was incompleted treatment, you understand. I’d been in bed a lot for ten years. I was told to continue my anti-microbe medicines, which was important for my progress, I think. I wish anti-pathogen treatment would be more recognized as part of veins health treatment. For example, see CPNhelp. org On a forum for MS and venoplasty for CCSVI, the people who got improvement seemed to be the ones who additionally treated pathogens. But maybe this is only for more debilitated sufferers than you.)

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