The Prevalence of Chronic Cerebrospinal Venous Insufficiency in Meniere Disease: 24-Month Follow-up after Angioplasty

J Vasc Interv Radiol. 2017 Mar;28(3):388-391. doi: 10.1016/j.jvir.2016.10.019. Epub 2016 Dec 27.

Abstract

Purpose: To evaluate relationship between Meniere disease (MD) and chronic cerebrospinal venous insufficiency (CCSVI) using ultrasound, magnetic resonance (MR) imaging, and venography and to evaluate the effectiveness of angioplasty of the internal jugular vein (IJV) and azygos vein (AV) in reducing symptoms of MD.

Materials and methods: Patients with a confirmed diagnosis of MD unresponsive to standard treatment underwent duplex ultrasound and MR imaging to diagnose CCSVI. Healthy volunteers were also studied to evaluate CCSVI in asymptomatic subjects. Patients with CCSVI and MD underwent venography and percutaneous transluminal angioplasty (PTA) of IJV and AV.

Results: There were 182 patients with no clinical benefit from standard treatments evaluated. CCSVI was diagnosed in 175 (87.5%) patients with MD. Venography was performed in 69 patients to confirm the diagnosis of CCSVI. In 80% of these patients, PTA of the IJV and/or AV was effective for treating signs and symptoms of MD. In the healthy cohort, CCSVI was observed in only 12% of subjects.

Conclusions: These results suggest a possible etiologic relationship between CCSVI and MD that warrants further investigation.

MeSH terms

  • Adult
  • Aged
  • Angioplasty, Balloon*
  • Azygos Vein* / diagnostic imaging
  • Case-Control Studies
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / therapy*
  • Chronic Disease
  • Female
  • Humans
  • Italy / epidemiology
  • Jugular Veins* / diagnostic imaging
  • Magnetic Resonance Angiography
  • Male
  • Meniere Disease / diagnostic imaging
  • Meniere Disease / epidemiology
  • Meniere Disease / therapy*
  • Middle Aged
  • Phlebography / methods
  • Prevalence
  • Risk Factors
  • Spinal Cord / blood supply*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / epidemiology
  • Venous Insufficiency / therapy*