This Is MS Multiple Sclerosis Community: Knowledge & Support

Hi,

I plan to have CCSVI treatment in the Summer, and have been told of the dangers of having stents.

So are balloons the safer and wiser option of the two, if i have CCSVI?

I contacted the clinic who will be doing the procedure and they said:
" If doctors decide that it is not dangerous i think they will allow for it"


If stents are more dangerous like i have been told, i would only want the balloons,

thanks

I'm currently analysing the same thing, and came to conclusion that best is maybe to consult the specialists after you have all your exams before intervention...it is very difficult to generalise. It will depend on the location and type of your stenosis.

Ballooning might be safer, but restenosis might occur, either after a week or month or whatever, or even immediately. Stents seem to be safe, depending on location. There has been one case of a stent migrating towards heart at Stanford, as direction of blood flow in veins is towards heart (vs away from heart for arteries). So there are certainly risks, but the interventionists if one consults them, should weigh them. Of course one can decide not to want a stent, taking then into account and accepting the fact that restenosis is a possibility to occur. This happened to many of Zamboni's patients and he now has for some done a second round ballooning, as when restenosis occured their symptoms came back...

the short answer is yes but please read my post at:
Dr. Zamboni words of caution on stents.

Yes, in fact there we discussed it already

Something that I have read about is "filters" in the Superior Vena Cava that are meant to catch embolisms, thromboses, etc., before they reach the lungs or heart. My understanding is that they are a temporary measure, until the intervention site has become static. That might take care of some of the migration issues, but then there are the long-term viability questions. I'm hopeful of living another 30 or 40 or 50 years, and wonder how long the stents can stay there.

For me, it will come down to an informed position after the imaging, as Zeureka wrote, with the final choice made when they are actually in the veins. My feeling right now is, no stents, unless the vein snaps back immediately with the ballooning. I'll take a year (or however long) of relief, and wait for the science to catch up. If I restenose and have to go back, I will. Hopefully, by that point I will be able to be treated at home.

My biggest problem right now is an inability to think clearly about anything, and a lack of information on stent science.

edit - good on you, Nunzio, for the short answer. Brevity is a challenge for me. Grin
/edit

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My name is not really Johnson. MSed up since 1993

Johnson, welcome to the club! Have exactly same thoughts - you express them very well

Steffi

I just went through a liberation procedure this week, and specified no stents.

For me, the bottom line is that all of the stents currently in use were designed specifically to be used in arteries. The anatomy of veins and arteries are completely different, and until stents are specifically designed for use in veins, I will avoid using them unless entirely necessary. Arterial stents, when dislodged, only get pushed further into the narrowing artery. The same stent placed in a jugular vein, if it were to become dislodged, has a clear pathway directly to the heart. Furthermore, stents have been known to fail over time, and such a failure in a vein could be absolutely disastrous.

Just my thoughts, but at this point I think it's much better to err on the side of caution...

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Marc
www.wheelchairkamikaze.com

Well done for your procedure Marc! Wow, read your blog, 5.5 hours...you're a strong guy!

It's great you made this decision (shows again what strong will you have!). There are stents that have also been specifically developed for veins for other purposes, but you are right that also those are still kind of experimental.

All my best wishes and we're all with you to hear follow-up! Fingers crossed that your first step treatment of angioplasty (where was possible) should already bring you some improvements!

Marc describes a very interesting thing within his procedure, which I think fits well into this thread. Thank you so much Marc for this!! And telling us the view of Dr Scalfani on stents, ballooning + problems with pathologic valves.

"Dr. Sclafani soon came in to explain his findings, which were that the right jugular was seriously occluded, and that although he tried with limited success to balloon it open, he didn't feel that it would stay open for very long. The options for addressing the abnormal valve that is causing the blockage are either the insertion of a stent, or a more traditional surgical procedure in which my neck would be cut open and the offending valve cut out. Neither of these options is particularly appealing, as Dr. Sclafani and I agree that until stents are designed specifically to be placed in the jugular vein, the risks involved in stenting the jugular are largely unknown and could be considerable. He suggested that the traditional surgical procedure might be the best option.

As for the obstruction in my azygos vein, Dr. Sclafani thinks that there is an instrument that he didn't have on hand during my procedure which he could use to reach the area of stenosis and balloon it open. This obstruction should remain open after ballooning, so we might decide to do another catheter procedure sometime in the near future."