Dr. Al-Omari at ISNVD

[Cece]

page 64 http://www.isnvd.org/files/ISNVD%20Abstract%20Book.pdf

Jugular valves play pivotal roles in the pathophysiology of CCSVI. Valve morphology is
highly variable. All pathologic valves in CCSVI patients are associated with altered
venous hemodynamics.

I agree with his conclusions, but I am not convinced that the images he shows corresponds with the valves that he has drawn. There is the funnel effect that a set of bad valves can make that he may have mistaken for the valves themselves. There is also the cusping effect of contrast coming back up under the cusps. IVUS would clarify. Valve morphology is a worthwhile and interesting topic. It may be that different presentations of valve respond better or worse to angioplasty. The more valve there is, the more residual valve material there will be afterwards, too. Longer leaflets have been suggested as problematic if they touch post-procedure and stick and cause restenosis.