The comparative analysis of non-thrombotic internal jugular vein stenosis and cerebral venous sinus stenosis

Purpose: To evaluate the feasibility and the outcomes of transjugular percutaneous endovascular treatment of dysfunctional hemodialysis access in patients with chronic kidney disease. Methods: A total of 50 transjugular treatments in 38 patients with arteriovenous fistulas or arteriovenous grafts from September 2011 to May 2015 were included in this study. Medical records and angiographies were retrospectively reviewed. Success rate, patency rate, procedure time, and complications including internal jugular vein stenosis were evaluated. Results: A total of 50 sessions of transjugular treatments were performed in 38 patients. There were 31 native arteriovenous fistulas including 10 immature cases and 19 arteriovenous grafts. Among the 50 cases, technical success was achieved in 45 and clinical success was achieved in 44; 37 cases (74%) with multiple stenotic sites were treated by the transjugular approach without placement of cross-sheaths. The mean time from puncture of the internal jugular vein to first fistulography was 10 min, and the mean total procedure time was 64 min. The primary patency rate at 6 months was 77%, while the secondary patency rate at 6 months was 97%. Perforation occurred in two cases during conventional percutaneous transluminal angioplasty after failure of the transjugular approach. One dissection occurred during the transjugular approach. There was no newly developed internal jugular vein stenosis during a mean follow-up period of 19.3 months. Conclusion: For the treatment of dysfunctional or immature hemodialysis access, the transjugular approach is a feasible and effective option that avoids injury to the graft or draining vein, especially in immature fistulas.

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Meningioma with dural venous sinus invasion and jugular vein extension

Journal of Neurosurgery Pediatrics ◽

10.3171/ped.2008.2.12.391 ◽

2008 ◽

Vol 2 (6) ◽

pp. 391-396 ◽

Cited By ~ 7

Author(s):

Shobhan Vachhrajani ◽

Andrew Jea ◽

John A. Rutka ◽

Susan Blaser ◽

Michael Cusimano ◽

...

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Jugular Bulb ◽

Venous Sinus ◽

Gross Total Resection ◽

Dural Sinus ◽

Intracranial Meningioma ◽

Total Resection ◽

Conventional Angiography ◽

Computed Tomography Scanning

Meningiomas represent the most common benign intracranial neoplasm in adults, with a considerably lower incidence in children. The authors present the case of an intracranial meningioma with invasion of, and intraluminal extension into, the transverse and sigmoid sinuses, jugular bulb, and internal jugular vein, resulting in venous occlusion in a 14-year-old girl. Computed tomography scanning, MR imaging, and conventional angiography were performed preoperatively. The patient underwent a 2-stage resection: the supratentorial component was resected first, and the infratentorial and venous sinus and jugular vein components were subsequently removed using a combined skull base approach. Gross-total resection was achieved by opening the lateral dural sinus and removing the meningioma from within the transverse and sigmoid sinuses, the jugular bulb, and the internal jugular vein. The patient remained neurologically intact after the staged tumor resections. Postoperative imaging confirmed the gross-total resection. This case illustrates the unusual property of an intracranial meningioma to invade the intrasinusoidal space and extend into the jugular vein without adherence to the underlying venous endothelium of the jugular vein.

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