Echocolor Doppler morpho-functional study of the jugulo-subclavian confluence in chronic cerebro-spinal venous insufficiency and multiple sclerosis patients

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COD: 06_2017_12-2351 Categorie: ,

Sandro Mandolesi, Aldo d’Alessandro, Antonello Ignazio Desogus, Marco Matteo Ciccone, Annapaola Zito, Immacolata Stammegna, Tarcisio Niglio, Augusto Orsini, Dimitri Mandolesi, Alessandro d’Alessandro§, Luca Revelli

Ann. Ital. Chir., 2017 88, 6: 546-552

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OBJECTIVES: The aim of this work is to measure the mean diameter of the confluence jugulo- subclavian, the impact of
different types of jugular confluences and the correlation between the types of confluences and the Valsalva maneuver
(jugular reflux) in subjects with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and Multiple Sclerosis.
METHOD: We investigated by Echo-Color-Doppler (ECD) 103 subjects (67 F 36M) of mean age 45 ± 12 years (a
minimum of 22 to a maximum of 79 years, with a median of 44 and a modal value 42 years), mean EDSS of 4.7
and average disease duration of 12 years.
RESULTS: The 103 right jugular veins investigated had an average diameter of 8.4 ± 2.4 mm (minimum 4.0, maximum
14.9 mm; median 7.9; modal value 7.6 mm). Three form types were found: 56 cylindrical, 29 conical and 18
funnel. Valsalva maneuver was positive in 30 patients. The 103 left jugular investigated had an average diameter of
8.9 ± 2.4 mm (minimum 2.8, maximum 14.4 mm; median of 8.8; modal value 8.7 mm). The form types were found:
42 cylindrical, 45 conical and 16 funnel. Valsalva maneuver was positive in 30 patients.
CONCLUSIONS: The mean diameter of the jugular veins was 8.7 mm. Internal jugular veins with cylindrical morphology
have a diameter smaller than other forms; this difference is statistically significant. The different morphology of the
jugular vein confluence does not increase the possibility of a reflux because the positive Valsalva maneuvers are not statistically
significant when compared to the various types.