Valves are only one issue.....

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

Valves are only one issue.....

Postby dania » Mon Jul 02, 2012 1:23 pm

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Re: Valves are only one issue.....

Postby Cece » Mon Jul 02, 2012 1:43 pm

The types of malformations found by Dr. Zamboni in his published research have included:

  • Annulus refers to significant circumferential stenosis of the whole venous wall;

  • Septum/valve malformation refers to anomalous valve apparatus causing significant flow obstacles at the level of the junction of the IJVs with the brachiocephalic/anonymous trunk;

  • Hypoplasia refers to under-developed long venous segments;

  • Twisting refers to severe stenosies in consequence of a twisted venous segment;

  • Membranous obstruction (web) refers to a membrane almost occluding a vein;

  • Agenesis refers to the complete anatomical absence of a venous segment.

I have been understanding annulus to mean the 'ring' of the valve, to which the leaflets attach. This is circumferential and it can be a stenosis, but it would always be as a component of the valve. Can an annulus exist without a valve, as defined here?

Valves are typically at the level of the junction of the IJVs with the innominate vein, but I thought septums could exist anywhere within the vein. A septum is not an anomalous valve aparatus but more of a sail or divider of the vein. I don't think they originate as valves but I don't know exactly how they do originate.

Hypoplasia can be long or short segments, but yes, underdeveloped veins. I do not think treatment of hypoplasias have been optimized. Low flow through hypoplasia increases the chance of clotting. Better to have a malformed valve or septum than a hypoplastic vein segment.

We don't hear much about membraneous obstruction and webs.

Agenesis may be the rarest of all of these.
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Re: Valves are only one issue.....

Postby NHE » Mon Jul 02, 2012 3:49 pm

Cece wrote:
The types of malformations found by Dr. Zamboni in his published research have included:

  • Twisting refers to severe stenosies in consequence of a twisted venous segment;


Dr. Sclafani has mentioned that twisted veins are uncommon.

chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic10680-6525.html?#p188457


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Re: Valves are only one issue.....

Postby dania » Mon Jul 02, 2012 4:16 pm

Size of veins also seems to be an issue. Mine are infantile not even juvenile. Others have reported that their veins are also small.
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Re: Valves are only one issue.....

Postby Music » Mon Jul 02, 2012 7:36 pm

These are my original MRV findings. Dania, maybe we have similar veins?? Mine are listed as diminutive - is this what they refer to as hypoplasia? What about the "flattening" reference? I don't know if I've seen this term before. CCSVI procedure found a malformed left valve.

"There is minimal-caliber flattening of the right internal jugular vein at the Cl level. Moderate-caliber
flattening is seen involving the right internal jugular vein as it passes beneath the stemocleidomastoid
muscle. It resumes normal caliber near its brachiocephalic confluence.

The left internal jugular vein is diminutive throughout much of its imaged length. There is significant
caliber flattening at the Cl level. Additionally, it remains diminutive as low as the C3-C4 level and is
accompanied by scattered small veins which may represent collaterals. It appears to demonstrate a
normal caliber at approximately the C4-C5 level and is moderately flattened as it traverses beneath the
stemocleidomastoid muscle. Its caliber appears normal at its brachiocephalic confluence. Both internal
jugular veins appear to enhance in an antegrade fashion on time-resolved, contrast-enhanced MR
venography".
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Re: Valves are only one issue.....

Postby dania » Mon Jul 02, 2012 7:49 pm

Mine are infantile everywhere. They must use a butterfly needle to get a blood sample from me. Cannot be done with a regular size needle. Plus every time they try to get a central line in it is hell. Takes some many times before they get it.
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Re: Valves are only one issue.....

Postby Music » Mon Jul 02, 2012 8:23 pm

Just had blood tests last week - couldn't find a vein in either arm - has happened before a couple of times - happens to my daughter too - finally use the top side of my hands.
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Re: Valves are only one issue.....

Postby dania » Mon Jul 02, 2012 8:37 pm

Tell them to use a butterfly needle. Smaller and a lot easier on everyone.
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