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Poor Internal Jugular Venous Outflow Is Associated with Poor Cortical Venous Outflow and Outcomes after Successful

Wenjin Shang1, Kaiyi Zhong1, Liming Shu2

  • 1Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China.

Brain Sciences
|January 21, 2023
PubMed

Insights

Poor internal jugular vein (IJV) outflow is linked to worse outcomes after endovascular reperfusion therapy (ERT) for acute stroke. This condition also predicts poor baseline cortical venous outflow, impacting patient recovery.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Interventional Radiology

Background:

  • Endovascular reperfusion therapy (ERT) improves outcomes in acute stroke, but many patients still experience poor results.
  • Poor cortical venous outflow is a recognized risk factor for adverse outcomes post-ERT.
  • The role of internal jugular vein (IJV) outflow in modulating venous drainage and stroke outcomes requires further elucidation.

Purpose of the Study:

  • To investigate the association between internal jugular vein (IJV) outflow and baseline cortical venous outflow.
  • To determine if IJV outflow influences clinical outcomes following successful ERT in acute anterior circulation stroke patients.

Main Methods:

  • Retrospective analysis of 78 patients with acute anterior circulation stroke and successful ERT.
  • Definition of poor IJV outflow: ipsilateral or bilateral internal jugular vein stenosis (≥50%) or occlusion.
  • Assessment of poor cortical venous outflow using the cortical vein opacification score (COVES) of 0 on admission.

Main Results:

  • Poor ipsilateral IJV outflow independently predicted hemorrhagic transformation after ERT.
  • Poor bilateral IJV outflow was an independent risk factor for poor clinical outcomes.
  • Poor IJV outflow was also an independent determinant of poor baseline cortical venous outflow.

Conclusions:

  • Reduced IJV outflow is associated with impaired baseline cortical venous drainage in stroke patients.
  • IJV outflow status is a significant predictor of both early complications (hemorrhagic transformation) and long-term clinical outcomes after ERT for acute large vessel occlusion stroke.

Keywords:
angiographyendovascular reperfusion therapyprognosisstrokevenous flow

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