These are separate problems. I would not characterize the doctors as using different approaches. Each MS patient will be different. Just because one shows high stenosis with lower occlusion, does not mean another can be treated in the same method or has the same valve issues. I think we risk getting into trouble second guessing vascular and interventional radiologists, or playing doctor.
In my Jeff's case, the lower jugulars were open just fine. Valves looked great. This is why the neck doppler test showed no problem. It was the pinching of the high jugular that created the collaterals, which disappeared after stenting, and have remained gone. Dr. Dake spent a lot of hours in the vertebral veins, azygos and lower jugulars twice...two four hour procedures-scanning the flow at all the different junctions. The venogram is the true test. We are confidant in his diagnosis and treatment, and have seen evidence on the correction in the monitoring of flow. He is our local doctor, and we are able to contact him for follow up and questions.
This has been my concern for patients traveling thousands of miles to receive treatment, and why I continue to urge a relationship with local doctors for followup. I know it's been tough for you to find anyone in the UK, L...and I completely sympathize. Sorry to seem brusque, but this distance issue is a concern for followup.
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09