jean2lyon Sam 11 Fév 2012 - 12:30
Bonjour, je post ici le descriptif d'une étude récente :
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The hypothesis of patho-physiological correlation between chronic cerebrospinal venous insufficiency and multiple sclerosis: rationale of treatment
1. M Lugli⇓,
2. M Morelli,
3. S Guerzoni and
4. O Maleti
+Author Affiliations
1. Department of Cardiothoracic and Vascular Surgery, Hesperia Hospital, Via Arquà, 80, 41100 Modena, Italy
Correspondence: Marzia Lugli MD
, Department of Cardiothoracic and Vascular Surgery, Hesperia Hospital, Via Arquà, 80, 41100 Modena, Italy. Email: lugli@chirurgiavascolaremodena.it
Abstract
Background The possible role of the venous system in the pathogenesis of chronic neurodegenerative diseases has been hypothesized for decades. Quite recently, the description of a venous condition defined as chronic cerebrospinal venous insufficiency (CCSVI) and its strong association with multiple sclerosis (MS) has brought back the attention of the scientific community to the hypothesis of an aetiological or concomitant role of an altered venous function in the occurrence of this pathology. CCSVI is identified by sonographic criteria, thus the indication for its possible treatment is based on ultrasound findings.
Method We retrospectively examined 167 consecutive patients affected by clinically defined MS and CCSVI, identified by ultrasound assessment by the presence of at least two sonographic criteria. Ultrasonographic diagnosis of CCSVI was then integrated by venography and intravascular ultrasound examination (in 43 patients). Patients were all submitted to endovascular procedure (venoplasty).
Results In 37% of cases there was no correspondence between the preoperative ultrasound assessment and the venographic findings. In the event of incongruity between venography and sonography, the intravascular ultrasound examination investigation, when performed, confirmed ultrasound findings in 42% of cases and venography results in 58%. At one month in 12% of cases ultrasound assessment showed the persistence of altered flux. In 67% of cases patients reported subjective amelioration, regarding non-specific symptoms.
Conclusion The pathophysiology of CCSVI is yet to be defined. The superior cava venous system is highly complex in terms of anatomy and possible anomalies, as well as its haemodynamic mechanisms. Further studies are required to define the parameters of diagnosis and treatment of CCSVI.
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Tout à fait Domyleen - le Pr D a fait cette "opération" à un vieux monsieur, non sep - problèmes coeur - tout s'est bien passé - et c'est ce que mon dr me dit : opération banale pour d'autres pathologies, et pour la sep, une affaire d'état!!!! je comprends pas grand chose..........
