History: Previous stent insertion into both internal jugular veins related to a background of multiple sclerosis.
Findings: On the left side there are overlapping stents in keeping with the given history. The lumen at the cranial and caudal limits of the stent is approximately 11 mm but there is a focal area of narrowing in the mid stent where the calibre reduces to 3 mm. This is not causing turbulence or demonstrable increase in velocity at the time of the study during quite respiration. The point of narrowing appears to correspond with an underlying transverse process from what is likely to be C1.
On the right side the appearances are entirely unremarkable with no narrowing, the stent being widely patent. More caudally the jugular veins are normal in appearance. Carotid appearances are normal.
Review of the outside CT from the London Bridge Hospital dated 2009 demonstrates that at that time the stents were widely patent and therefore this slight angulation and narrowing is a new phenomenon. The significance of this non obstructing relative stenosis is debatable and clinical correlation would be required.
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