title: Efficacy and safety of cutting balloons for the treatment of obstructive lesions in the internal jugular veins.
abstract: BACKGROUND
  In this technical note we present the results of endovascular treatment for chronic cerebrospinal venous insufficiency with the use of cutting balloons, with focus on feasibility and safety of these endovascular devices.
  
  
  METHODS
  We used cutting balloons during 70 procedures in 65 multiple sclerosis patients presenting with strictures of the internal jugular veins, primarily at the level of jugular valves. These devices were used only in selected cases, following unsuccessful standard balloon angioplasty, and on condition that commercially available devices could be applied (currently they are maximally 8 mm in diameter).
  
  
  RESULTS
  In all cases the perioperative course was uneventful, with no serious adverse events. Immediate technical success rate was 94.3%. In four cases (5.7%) cutting-balloon angioplasty alone was unsuccessful and stents were implanted. Primary, assisted primary and secondary patency rates after 6 months were: 94%, 98.5%, and 98.5%, respectively. Follow-up has revealed that out of the remaining 66 angioplasties four procedures failed (failure rate: 6.1%): in two patients stents were implanted, in one patient successful redo cutting-balloon angioplasty was performed, while in another case the treated segment of jugular vein totally occluded and was not feasible to reopen endovascularly.
  
  
  CONCLUSIONS
  Cutting balloons can be safely used for the management of stenosed internal jugular veins. These devices can replace stents in the majority of cases, especially if standard balloon angioplasty is insufficient to restore proper outflow. However, the use of cutting balloons in this particular venous territory is limited by the fact that currently only small diameter devices are available.
authors.affiliation: Euromedic Medical Center, Department of Vascular Surgery, Katowice, Poland - mariansimka@poczta.onet.pl.
authors.forename: Marek
authors.initials: M
authors.lastname: Kazibudzki
authors.forename: Pawel
authors.initials: P
authors.lastname: Latacz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Ludyga
authors.forename: Marian
authors.initials: M
authors.lastname: Simka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002560:Cerebrovascular Circulation; D002908:Chronic Disease; D003251:Constriction, Pathologic; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis; D012039:Regional Blood Flow; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices; D014654:Vascular Patency; D014689:Venous Insufficiency / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult