measurement of azygous blood flow

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

measurement of azygous blood flow

Postby Cece » Tue Jul 19, 2011 7:29 pm

Endoscopic Doppler Ultrasound for Measurement of Azygos Blood Flow: Validation against Thermodilution and Assessment of Pharmacological Effects of Terlipressin in Portal Hypertension

2001, Vol. 36, No. 3 , Pages 318-325 (doi:10.1080/00365520120159)
PDF (198 KB) PDF Plus (199 KB) ReprintsPermissionsE. F. Hansen, F. Bendtsen, K. Brinch, S. Møller, J. H. Henriksen, U. Becker
Depts. of Medical Gastroenterology and Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, University of Copenhagen, Denmark




Background: Endoscopic ultrasound (EUS) is a new modality allowing real-time flow measurements by means of the Doppler technique. The aim of the study was to evaluate azygos blood flow measurements by endoscopic ultrasound. Methods: Measurements of azygos blood flow by EUS and by the thermodilution technique were compared in 20 patients with portal hypertension. The ability of EUS flowmetry to detect changes in the azygos and portal venous flow after an intravenous dose of 2 mg of terlipressin was evaluated in 13 of the patients in a double-blind, randomized, placebo-controlled, cross-over design. Results: The EUS Doppler and thermodilution measurements correlated significantly (R = 0.81, P < 0.001). The azygos blood flow was found to be 14% higher by the EUS method than by thermodilution. The coefficient of variation of the EUS Doppler measurements of the azygos blood flow was 14.8%. After administration of terlipressin, the azygos blood flow, as measured by EUS Doppler, decreased significantly by 23% from 915 to 704 ml/min (P = 0.014) and the portal venous flow decreased by 28% from 1170 to 789 ml/min (P = 0.03). No effects of placebo were detected. Conclusions: These results show that EUS measurement of the azygos blood flow correlate strongly to the measurements by the thermodilution technique, and EUS is moreover well tolerated by the patients. The method is applicable for monitoring pharmacological effects on the superior porto-systemic collateral circulation and portal venous flow in patients with portal hypertension.




Read More: http://informahealthcare.com/doi/abs/10 ... alCode=gas

Are these noninvasive ways to measure the azygous blood flow? Would this be of use in CCSVI?
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Postby Cece » Tue Jul 19, 2011 7:39 pm

on a separate note, but also related to the azygos vein:
www.urmc.rochester.edu/radiology/educat ... ase472.cfm
Discussion: Azygos vein enlargement is defined as an azygos vein measuring greater than 7 mm diameter on an upright chest radiograph. It can be secondary to a number of different disease states involving two primary categories: a need for collateral circulation and engorgement due to right atrial hypertension. The azygos vein becomes a collateral vessel in the following states: portal hypertension, SVC obstruction/compression below the azygos vein, IVC obstruction/compression, interrupted IVC with azygos continuation, and partial anomalous venous return. Azygos enlargement is seen with right atrial hypertension in right-sided heart failure, constrictive pericarditis, and large pericardial effusion.

The patient in this case had incidental azygos vein enlargement secondary to pulmonary arterial hypertension and right-sided heart failure.

Azygos vein enlargement due to it being used as a collateral vessel.
My azygos was enlarged.
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Postby Gardenia » Thu Jul 21, 2011 12:22 pm

Mine was the opposit, the azygous vein was the width of a hair for a short distance. It's interesting bc I haven't walked for 8 years, not paralyzed bbut unable to use them, stand, move them after breaking shin bone.
The doctor had some difficulty getting it wider to say the least. 80% blockage to only 50% blockage. Guess it's better than it was. Unfortunately I reside in CANADA=still sort of screwed.
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Postby Cece » Thu Jul 21, 2011 12:28 pm

That is better than it was, it's at least something. Was a stent not a possibility?

Canadians may be screwed at the moment (and for the last two years) but with the federal trials beginning, it is not going to last forever.
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Postby Gardenia » Thu Jul 21, 2011 1:09 pm

Yeah but nothing is up and running so that could be a long wway off, I believe they just agreed to help fund, but not quite sure what that will really mean. Given the problems with stenting or perceived probs with it, the dr didn't want to stent but as a last resort. God you are very luck if you are American and not if Canadian!
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Postby Johnson » Thu Jul 21, 2011 4:20 pm

Cece wrote:---redacted---

Canadians may be screwed at the moment (and for the last two years) but with the federal trials beginning, it is not going to last forever.


Joan mentioned this at her Facebook page, but I have not seen it here. I have (and had) little confidence in the announcement. I've been Canadian for too long, I suppose - what with the LaDaine Commission being over 40 years ago...

Researchers of controversial MS theory facing series of hurdles
CARLY WEEKS
From Tuesday's Globe and Mail
Published Monday, Jul. 18, 2011 7:26PM EDT
Last updated Monday, Jul. 18, 2011 8:10PM EDT

North American researchers investigating the controversial Zamboni theory of multiple sclerosis are running into a host of problems with their trials that threaten to delay meaningful results.

The problems, documented in a new progress report, call into question the timing of Ottawa’s decision last month to announce support for formal clinical trials of the vein-widening treatment in Canada.

Problems with the trials include difficulty recruiting study participants, challenges figuring out how to properly identify and diagnose venous problems and trouble obtaining ethics approval to conduct research.

linky

I find it hard to believe that they have trouble recruiting research subjects with ~75,000 Canadians with "MS"
'If you think we're wax-works,' he said, 'you ought to pay, you know. Wax-works weren't made to be looked at for nothing. Nohow.'

'Contrariwise,' added the one marked "DEE", 'if you think we're alive, you ought to speak.'

'I'm sure I'm very sorry,' was all Aglukkaq could say; for the words of the old song kept ringing through her head like the ticking of a clock, and she could hardly help saying them out loud:

Tweedledum the Neurologist and Tweedledee the Phlebologist
Agreed to have a battle!
For Tweedledum said Tweedledee
Had spoiled his nice old rattle.

Just then flew down a monstrous crowd of sick people,
As black as a tar-barrel!
Which frightened both the heroes so,
They quite forgot their quarrel.'


'I know what you're thinking about,' said Tweedledum; 'but it isn't so, nohow.'

'Contrariwise,' continued Tweedledee, 'if it was so, it might be; and if it were so, it would be; but as it isn't, it ain't. That's logic.'

---redacted---

'But it certainly was funny,' (Aglukkaq said afterwards, when she was telling her sister the history of all this), 'to find myself singing "Here we go round the mulberry bush." I don't know when I began it, but somehow I felt as if I'd been singing it a long long time!'
(With thanks, and apology to Lewis Carroll)
My name is not really Johnson. MSed up since 1993
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