Endovascular treatment of a right internal jugular vein occlusion in a hemodialysis patient with severe neurological symptomatology

Martina Maria Giambra; Gaetano Lomonaco; Maria Grazia Lumia; Marco Barbanti; Francesco Setacci; Alessia Giaquinta; Giuseppe Roscitano; Massimiliano Veroux; Pierfrancesco Veroux

doi:10.4081/vl.2023.12145

Authors

Martina Maria Giambra
giambramartina@gmail.com
Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania, Italy. https://orcid.org/0000-0001-9911-5227
Gaetano Lomonaco Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania, Italy.
Maria Grazia Lumia Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania, Italy. https://orcid.org/0009-0004-7007-3755
Marco Barbanti University Kore of Enna, Italy.
Francesco Setacci Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania; University Kore of Enna;, Italy.
Alessia Giaquinta Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania, Italy.
Giuseppe Roscitano Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania, Italy.
Massimiliano Veroux Organ Transplant Unit, Department of Surgical and Medical Sciences and Advanced Technologies, University Hospital of Catania, Italy.
Pierfrancesco Veroux Division of Vascular Surgery, A.O.U. Policlinico “G. Rodolico - San Marco”, University of Catania, Italy. https://orcid.org/0000-0003-4965-7137

In the last decade, Internal Jugular Vein (IJV) obstructive disease has been gaining increasing attention due to different confounding symptoms that impair patients’ quality of life and cannot be explained by other established causes. The most common clinical symptoms associated with IJV stenosis are tinnitus and sleep disturbances (60.5%), headache (48.8%), visual disturbances (39.5%), hearing disorders (39.5%) and anxiety or depression (37.5%). We report a complex case of a woman with a wide range of severe neurological inexplicable disorders. Using Duplex Ultrasound, an IJV occlusion was successfully diagnosed and the patient was then treated using endovascular techniques. IJVs occlusion and outflow alteration were detected by the means of Duplex Ultrasound (DUS) demonstrating the need of a carefully assessment of neck vessels in patients with drug-resistant neurological symptomatology as headache, tinnitus and sleep disturbances.

Zhou D, Ding J, Asmaro K, et al. Clinical Characteristics and Neuroimaging Findings in Internal Jugular Venous Outflow Disturbance. Thromb Haemost. 2019;119:308-18. DOI: https://doi.org/10.1055/s-0038-1676815

Veroux P, Giaquinta A, Perricone D, et al. Internal jugular veins out flow in patients with multiple sclerosis: a catheter venography study. J Vasc Interv Radiol. 2013;24:1790-7. DOI: https://doi.org/10.1016/j.jvir.2013.08.024

Lupattelli T, Onorati P, Bellagamba G, Toma G. Successful retrograde recanalization of internal jugular vein passing from omolateral external jugular vein. Veins and Lymphatics. 2018;7:7745. DOI: https://doi.org/10.4081/vl.2018.7745

Yevzlin AS. Hemodialysis catheter-associated central venous stenosis. Semin Dial. 2008;21:522-7. DOI: https://doi.org/10.1111/j.1525-139X.2008.00496.x

Beggs CB, Giaquinta A, Veroux M, et al. Mid-term sustained relief from headaches after balloon angioplasty of the internal jugular veins in patients with multiple sclerosis. PLoS One. 2018;13:e0191534. DOI: https://doi.org/10.1371/journal.pone.0191534

Toro EF, Borgioli F, Zhang Q, et al. Inner-ear circulation in humans is disrupted by extracranial venous outflow strictures: Implications for Ménière’s disease. Veins and Lymphatics. 2018;7:7156. DOI: https://doi.org/10.4081/vl.2018.7156

Tessari M, Ciorba A, Mueller LO, et al. Jugular valve function and petrosal sinuses pressure: a computational model applied to sudden sensorineural hearing loss. Veins and Lymphatics 2017;6:6707. DOI: https://doi.org/10.4081/vl.2017.6707

Zamboni P, Galeotti R, Salvi F, et al. Effects of Venous Angioplasty on Cerebral Lesions in Multiple Sclerosis: Expanded Analysis of the Brave Dreams Double-Blind, Sham-Controlled Randomized Trial. J Endovasc Ther. 2020;27:1526602819890110. DOI: https://doi.org/10.1177/1526602819890110

Giaquinta A, Beggs CB, Veroux M, et al. Factors influencing the hemodynamic response to balloon angioplasty in the treatment of outflow anomalies of internal jugular veins. J Vasc Surg Venous Lymphat Disord. 2017;5:777-88. DOI: https://doi.org/10.1016/j.jvsv.2017.06.015

Bavera PM. May symptoms of chronic cerebrospinal venous insufficiency be improved by venous angioplasty? An independent 4-year follow up on 366 cases. Veins and Lymphatics 2015;4:5400. DOI: https://doi.org/10.4081/vl.2015.5400

Giambra, M. M., Lomonaco, G., Lumia, M. G., Barbanti, M., Setacci, F., Giaquinta, A., Roscitano, G., Veroux, M., & Veroux, P. (2023). Endovascular treatment of a right internal jugular vein occlusion in a hemodialysis patient with severe neurological symptomatology. Veins and Lymphatics, 12(1). https://doi.org/10.4081/vl.2023.12145