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Vascular Surgery 2019
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 54
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
S Spagnolo
GVM Care & Research, Italy
S Spagnolo, J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-005
T
hechronicuppercavalsyndromerunsasymptomatically.
No symptomatic outcomes that characterize
this condition have been identified. It is possible that
anatomopathological changes and clinical pictures that
could characterize moderate stenosis have been attributed
to various neurological diseases such as multiple sclerosis,
Parkinson’s disease, Meniere’s syndrome, etc. Only in recent
years in patients with multiple sclerosis or Parkinson’s
disease have the presence of stenosis of the jugular veins
been detected. Little is known about the clinical pictures this
pathology determines. With the introduction in the vascular
diagnostics of the Ecocolordoppler, of the angiography and
of theMRI, vascular flows and anatomopathological lesions
that characterize these stenoses have been highlighted.
At the Ecocolordoppler it is documented that the venous
blood, coming from the brain, reached the point of stenosis,
reverses its flow direction and re-enters the cerebral
circulation. This inversion of the circulation has been called
reflux. Starting fromthe concept that the venous circle has a
unidirectional and centripetal flowand that a countercurrent
flow is possible only in the compensation circles, we
hypothesized and then demonstrated angiographically
that the entire cerebrospinal venous system functions as a
compensation circle. In our view, the reflux is not due to an
inversion of the circolocerebral flow but to the venous blood
that from the veins of the head, neck and throat reaches
the jugular vein and, being unable to descend towards the
heart, rises towards the cerebral circulation . It has been
documented angiographically that blood from the jugular
veins passes into the cerebral circulation, descends into the
medullary circle, reaches the vein azigos and reaches the
heart. The inversion of the circulation in the jugular vein and
in the cerebral veins and the continuous passage of blood
from the oral cavity, often the site of viruses, to the brain
and the medulla open new perspectives in the knowledge
of the mechanisms of brain plaque formation. In patients
with jugular vein stenosis, the direction of cerebral venous
circulation is impaired. The blood from the jugular veins, the
sigmoid sinuses, the transverse sinuses and the superior
sagittal sinus, to reach the medullary veins, must cross the
right breast and its tributary branches. The sinus rectum
is a single conduit, constantly subjected to an overload
of pressure and volume and with a circulation that runs
counter-current. It puts in direct contact the viruses present
in the oral cavity or in the pharynxwith the nervous tissue.All
these factors compromise the blood-brain barrier and allow
viruses and anti-viral antibodies to reach the brain where
they trigger an inflammatory processwith plaque formation.
If further confirmations corroborate this hypothesis, it will
be possible to conclude that the opening of jugular stenosis
leads to the normalization of cerebrospinal circulation and
the elimination of the causes that lead to the formation of
inflammatory processes in multiple sclerosis and other
neurodegenerative diseases.
Recent Publications
1. Sy WM and Lao R S (1982) Collateral pathways
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 in
Thoracic Surgery”, book edited by Paulo F
Chronic superior vena cava syndrome: Causes of venous
shunt from the systemic to the cerebral circulation and
causes of cerebrospinal sclerotic plaques formation