Table 2 Advantages and disadvantages of invasive diagnostic methods for diagnosis of chronic cerebrospinal venous insufficiency
Invasive diagnostic methods | Advantages | Disadvantages |
|---|---|---|
- 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 | ||
- 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 |