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IJV valves in cadavers

Posted: Mon Dec 06, 2010 6:06 pm
by Cece
last one from me for now :)

If anyone has access to the full articles, perhaps they could take a look and see if the authors found anything resembling the sort of IJV valve malformations that we see in CCSVI? These are both research papers on cadavers (non MS) looking at IJV valves.

http://www.ncbi.nlm.nih.gov/pubmed/1041 ... t=Abstract

http://www.ophsource.org/periodicals/op ... LN.3455235

Posted: Mon Dec 06, 2010 6:59 pm
by dreddk
7% incidence of incompetent valves which can cause reflux in cadavears


http://www.ncbi.nlm.nih.gov/pubmed/12076346

Posted: Mon Dec 06, 2010 7:18 pm
by Cece
RESULTS: The IJVV was present in all cadavers just before its termination (60 IJVVs from 30 subjects). The valve was bicuspid in most cases (93%). The competence of 41 IJVVs was checked of which only three (7%) were found to be incompetent. All IJVVs in live subjects were found to be competent.
good find, dreddk.

The problem is that there's two types of incompetent valves; the CCSVI type is malformed, the other type allows the other type of reflux (backflow) as opposed to the CCSVI type of reflux (trapped and can't get out that way). We don't know which of the 7% is which type. It might describe them more in the actual article.

Before when we've said that we don't know the incidence of CCSVI in the healthy population, maybe we do, if so much of CCSVI is these malformed valves, then this is an area that has seen some study.

Posted: Mon Dec 06, 2010 7:49 pm
by dreddk
IJV reflux or stensosis has been seen in normal subjects and in patients with non-ms diseases. I (personally) think its relatively common and not that big a deal.

http://www.ncbi.nlm.nih.gov/pubmed/19926838

http://www.ncbi.nlm.nih.gov/pubmed/19252781

Posted: Mon Dec 06, 2010 8:15 pm
by fernando
dreddk wrote:IJV reflux or stensosis has been seen in normal subjects and in patients with non-ms diseases. I (personally) think its relatively common and not that big a deal.

http://www.ncbi.nlm.nih.gov/pubmed/19926838

http://www.ncbi.nlm.nih.gov/pubmed/19252781
Let me add that those studies look at reflux during valsalva maneuver. Reflux during normal circumstances is CCSVI.
Valsalva maneuver. Valvular insufficiency was diagnosed when there was reflux for >0.8 seconds during the Valsalva maneuver.

Posted: Mon Dec 06, 2010 8:24 pm
by Cece
I agree, Fernando, what's being called valve insufficiency is the other type, where it's weak and allows backflow from the heart, not the CCSVI type, where it's fixed as an outflow obstruction.

But the cadavers aren't doing Valsalva 8O
Can't do much without full articles, I'll see what I can do about getting them....

Posted: Mon Dec 06, 2010 11:53 pm
by drsclafani
Cece wrote:I agree, Fernando, what's being called valve insufficiency is the other type, where it's weak and allows backflow from the heart, not the CCSVI type, where it's fixed as an outflow obstruction.

But the cadavers aren't doing Valsalva 8O
Can't do much without full articles, I'll see what I can do about getting them....
i am going to put a case on my thread that illustrates the level of narrowing that one can see in ccsvi. this would clearly be commented upon if noted in normal cadavers

Posted: Fri Dec 10, 2010 8:08 am
by Cece
I turned up a full paper on internal jugular valves in cadavers. No mention of anything CCSVI-ish. I agree with drsclafani, I think it would be mentioned. The valves are well described.

http://www.springerlink.com/content/x14 ... lltext.pdf

Here is an image from the paper:
http://www.springerlink.com/content/x14 ... lltext.pdf[/quote]
Image
Fig. 1. a Jugulo-subclavian venous junction opened anteriorly in a formalin-fixed anatomical preparation demonstrating: 1 the internal jugular vein; 2 the subclavian vein; 3 the brachiocephalic or innominate vein; and 4 the posterior leaflet of a bicuspid internval jugular vein b Higher magnification of the same image with good visualization of the valvular structure. The paper is inserted into the posterior cusp.