Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe?

OBJECTIVES: The aim of this report is to assess the safety of endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI). Although balloon angioplasty and stenting seem to be safe procedures, there are currently no data on the treatment of a large group of patients with this vascular pathology. METHODS: A total of 564 endovascular procedures (balloon angioplasty or, if this procedure failed, stenting) were performed during 344 interventions in 331 CCSVI patients with associated multiple sclerosis. RESULTS: Balloon angioplasty alone was performed in 192 cases (55.8%), whereas the stenting of at least one vein was required in the remaining 152 cases (44.2%). There were no major complications (severe bleeding, venous thrombosis, stent migration or injury to the nerves) related to the procedure, except for thrombotic occlusion of the stent in two cases (1.2% of stenting procedures) and surgical opening of femoral vein to remove angioplastic balloon in one case (0.3% of procedures). Minor complications included occasional technical problems (2.4% of procedures): difficulty removing the angioplastic balloon or problems with proper placement of stent, and other medical events (2.1% of procedures): local bleeding from the groin, minor gastrointestinal bleeding or cardiac arrhythmia. CONCLUSIONS: The procedures appeared to be safe and well tolerated by the patients, regardless of the actual impact of the endovascular treatments for venous pathology on the clinical course of multiple sclerosis, which warrants long-term follow-up.

[The value of electroneurography in recognition of peripheral ischaemic polyneuropathy in patients suffering from critical leg ischaemia]. / Wartosc badan EMG w rozpoznaniu polineuropatii niedokrwiennej u chorych z krytycznym niedokrwieniem konczyn dolnych.

Peripheral arteries disorders cause not only leg ischaemia, but also peripheral polyneuropathy. Polyneuropathy increases ischaemic pain. The aim of this study was to estimate how many patients suffering from critical leg ischaemia have symptoms of peripheral polyneuropathy. 40 patients were investigated: 37 men and 3 women; mean age was 57 years. All patients underwent electroneurographic examination. It consisted of measurements of motor conduction in tibial and peroneal nerves, wave F, sensory conduction in sural nerve. Polyneuropathy was observed in 95% of patients. The frequency of polyneuropathy was also significantly enlarged in leg with non critical ischaemia. We did not observe the greater risk of polyneuropathy in diabetic patients. The work is an introduction to the following clinical studies.

[Abdominal aortic aneurysm ruptured into duodenum]. / Pekniecie tetniaka aorty brzusznej do dwunastnicy.

We described a case of abdominal aortic aneurysm ruptured into duodenum. It was diagnosed successfully before laparotomy using duodenoscopy. We think that gastrointestinal endoscopy allows to make a correct diagnosis.