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Vascular Surgery 2019
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 28
Chronic superior vena cava syndrome:
cause of continuous passage of blood
from the territory of venous system to
the cerebrospinal venous circulation
and possible cohorts for several
neurodegenerative diseases
S Spagnolo
GVM Care & Research, Italy
I
n superior vena cava syndrome (SVCS), the venous
blood from the upper torso reaches the right
atrium through four well-known collateral pathways.
Unexpectedly, numerous imaging studies showed that
in the left brachiocephalic venous stenosis the blood
reverses its flowdirectionandheads towards the jugular
and cerebral veins. Venous flow direction is always
unidirectional and centripetal, while the bidirectional
flow is a unique feature of compensatory venous circle.
The jugular vein reflux, well described in the literature,
can only be interpreted as a typical centrifugal flow
of a collateral circulation. Our hypothesis is that the
cerebrospinal venous system itself constitutes a
compensation circle, which connects the superior vena
cava to the inferior one. This hypothesis is corroborated
by the current knowledge on the cerebrospinal
venous system that is considered a unique, valve less,
bidirectional flow circuit that freely communicates with
superior and inferior vena cava. From 2010 to today we
have operated for plastic enlargement with patches
in the saphenous vein, 120 patients with congenital
stenosis of the superior vena cava system. Here we
report the angiography of first two patients with vena
cava stenosis; in one we describe the inversion of
flow from the location of the obstruction towards the
cerebrospinal circle and in the other we describe the
passage of venous blood from peripheral tissues to
the cerebrospinal circle. The continuous passage of
venous blood from the superior cava system into the
cerebrospinal circulation opens up new perspectives
in the explanation of etiopathogenesis of many
neurodegenerative diseases (infant neurological
diseases, multiple sclerosis, Parkinson’s disease
and Alzheimer’s). In vena cava stenosis then, the
cerebrospinal circle is subjected to an increase in
pressure, in volume overload and in the possibility, as
demonstrated in literature, that infections, emboli or
tumors can be transmitted directly from the periphery
to the brain through the venous route
Recent Publications:
1. SyWMandLaoRS(1982)Collateralpathways
in superior vena cava obstruction as seen on
gamma images. Br J Radiol 55:294-3004.
2. Francesco Puma and Jacopo Vannucci
(2012) Superior vena cava syndrome, “Topics
S Spagnolo, J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-004