Table 2

Advantages and disadvantages of invasive diagnostic methods for diagnosis of chronic cerebrospinal venous insufficiency
Invasive diagnostic methods Advantages Disadvantages
Catheter venography[28,34,42,43,45-51] - considered gold standard - invasive method
- real time information can be obtained by using contrast - ionizing radiation
- ability to measure pressure - cannot be performed without contrast (allergy, toxicity)
- provide “road map” for planning endovascular procedures - operator dependent
- can be complemented by use of more sophisticated criteria (time to empty contrast from vein or wasting of the balloon) - time consuming (>45 minutes)
- cannot detect intra-luminal abnormalities
- no global view of veins and collaterals
- no standardized definition of significant vein stenoses
Intravascular ultrasound[47,107,108] - offers a 360° view of the vessel’s wall from the inside - invasive method
- can detect intra-luminal abnormalities - lack of experience - no standardized protocols
- easily accesses all parts of IJVs in comparison with DS - ring down artifacts
- provides more accurate assessment of vein stenosis and wall thickness than CV and DS - geometric distortion - from imaging in an oblique plane
- size of IVUS probe - limitation in the imaging of severe stenosis

Legend: CV, catheter venography; DS, Doppler Sonography; IVUS, intravascular ultrasound.

Dolic et al.

Dolic et al. BMC Medicine 2013 11:155   doi:10.1186/1741-7015-11-155

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