Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery · 2023
[The internal jugular veins outflow with varying degrees of internal carotid arteries stenosis using ultrasound assessment].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Bukhovets I L, Maksimova A S, Kuznetsov M S, Kozlov B N, Stepanov I V, Zavadovsky K V, Ussov W Yu
Аннотация
BACKGROUND: In the progression of atherosclerotic lesions of the brachiocephalic arteries, disturbances occur interdependently in the venous system, its extra- and intracranial sections. Therefore, an adequate assessment of the venous component of cerebral hemodynamics should be an important addition to the study of the arterial bed. The most common diagnostic method for detecting pathological changes in cerebral vessels today is ultrasound. However, there is still not enough information about which parameters clinically most valuable reflect venous remodeling and outflow disturbance. Changes in the structural and functional parameters of the internal jugular veins with varying degrees of stenosis of the carotid arteries were studied in fragments.
AIM: To study the venous outflow through the internal jugular veins at different degrees of the internal carotid arteries stenosis.
MATERIAL AND METHODS: The study included 91 patients who underwent ultrasound examination of the carotid arteries and internal jugular veins. According to the ultrasound results, patients were initially divided into three groups: group 1 (main) - 26 patients with hemodynamically significant stenosis of the internal carotid arteries of 70% or more by area (stenosis of 'high' degree), group 2 (comparison) - 31 patients with stenosis of the ICA 50-60%, which we defined as 'borderline', group 3 (control) - 34 patients with stenosis of the ICA less than 30% ('small' stenoses). In 9 patients, a comprehensive MR-tomographic and MR-angiographic examination of the brain was performed.
RESULTS: In the group with 'high' degree stenoses, the venous peripheral and central venous pressure were statistically significantly lower, the area of the internal jugular vein were larger, and the linear velocity and volumetric flow rate on the side of the stenosis were higher than in the groups with 'borderline' and 'small' stenoses. The indicators in the group of 'borderline' stenoses were statistically significantly different from the group with 'high' degree stenosis and did not differ from the indicators of the control group, the division of this group into two subgroups: with stenoses up to 55% and more than 55% showed a statistically significant difference in linear velocity and volumetric flow rate as between subgroups and between the subgroup with stenoses greater than 55% and the control group.
CONCLUSION: Evaluation of the geometric and hemodynamic parameters of the internal jugular veins during a comprehensive ultrasound examination in patients with various degrees of stenosis allows clarifying the hemodynamic significance of stenotic lesions of the internal carotid arteries and then confirming the significant nature of the stenosis on MRA. Quantitative assessment of venous blood flow should be included in the complex ultrasound examination in patients with carotid atherosclerosis.
AIM: To study the venous outflow through the internal jugular veins at different degrees of the internal carotid arteries stenosis.
MATERIAL AND METHODS: The study included 91 patients who underwent ultrasound examination of the carotid arteries and internal jugular veins. According to the ultrasound results, patients were initially divided into three groups: group 1 (main) - 26 patients with hemodynamically significant stenosis of the internal carotid arteries of 70% or more by area (stenosis of 'high' degree), group 2 (comparison) - 31 patients with stenosis of the ICA 50-60%, which we defined as 'borderline', group 3 (control) - 34 patients with stenosis of the ICA less than 30% ('small' stenoses). In 9 patients, a comprehensive MR-tomographic and MR-angiographic examination of the brain was performed.
RESULTS: In the group with 'high' degree stenoses, the venous peripheral and central venous pressure were statistically significantly lower, the area of the internal jugular vein were larger, and the linear velocity and volumetric flow rate on the side of the stenosis were higher than in the groups with 'borderline' and 'small' stenoses. The indicators in the group of 'borderline' stenoses were statistically significantly different from the group with 'high' degree stenosis and did not differ from the indicators of the control group, the division of this group into two subgroups: with stenoses up to 55% and more than 55% showed a statistically significant difference in linear velocity and volumetric flow rate as between subgroups and between the subgroup with stenoses greater than 55% and the control group.
CONCLUSION: Evaluation of the geometric and hemodynamic parameters of the internal jugular veins during a comprehensive ultrasound examination in patients with various degrees of stenosis allows clarifying the hemodynamic significance of stenotic lesions of the internal carotid arteries and then confirming the significant nature of the stenosis on MRA. Quantitative assessment of venous blood flow should be included in the complex ultrasound examination in patients with carotid atherosclerosis.