drsclafani wrote:But was IVUS done? how many views?
I think, that you ask this question, it shows your own belief that IVUS adds useful information; you've got me convinced as well. But if people here want to be treated by a doctor using IVUS, it is still true that nobody is using IVUS? How did the gathered doctors respond to your speech on IVUS?
IVUS is not reimbursed by insurers and the catheter is quite expensive (about $650). The IVUS unit is also expensive. These costs have to be absorbed by someone. Let me ask you this: if you had to pay for the catheter as an extra, would you pay it?
Lately with the emergence of so many more docs on the field, they all have different strategies. I know of a doc doing unilateral ballooning, so if both jugulars need ballooning, he schedules them for different days. (This is quite cautious?)
this is quite proposterous!
I know of Dr. Sinan's seemingly brilliant strategy, where he balloons aggressively in the azygous and uses larger sized balloons...I asked before what you thought of that one, but maybe it is too early or impolite to be asked to evaluate other docs' strategies?
Tariq has not yet shown outcomes using those large diameters of dilatation. He did show, however, that the vein could tolerate those diameters . It was very helpful to see that the frontier.
I have been working my way through some of girlgeek's videos. Fantastic stuff. Some things that caught my attention:
The SUNY videographer is taking a long time. I hope that we can get the entire conference on internet asap.
* You saying "Shame on us" for not following up on old old research showing the venous/MS connection. Great speech.
Shame on all of us. Lots of MSers missed it too. But its old stuff. Now let's drop the shame and preoccupation with blame and anger, and focus on the next phase of discovery. A hell of a lot to do. I am so looking forward to treating again.
* None of the speakers were subsidized? Not even their travel expenses covered? If you are able to do this next year, will this change?
Absolutely nothing. Dr Petrov volunteered to come from bulgaria. arrived on sunday night, returned on monday night. Dr. Siskin drove from albany starting at 5am monday, returned after dinner to albany at 10pm.
Isnt that amazing. Such great altruism was just demonstrated!. Brings tears to my eyes.
NOT ONE DOLLAR FROM PHARMA OR CATHETER COMPANIES, OR ANGIO OR ULTRASOUND EQUIPMENT MANUFACTURERS.
I cannot afford this every year. The next one will require an entry fee of some form and we will surely have to fund some transportation as we bring more people together.
* What did you think of the question asked to Dr. Salvi, I believe, about diabetes (?) research from the 90s that showed that when blood flow was cut off to nerves, their functioning decreased and when it was restored, it improved? This is relevant to what is being found with immediate improvements in CCSVI, isn't it?
i am going to have to review the videotape before i make comments on that one.
* Dr. Haacke talked about that since arteries bring in blood at high speeds and it leaves in the veins at low speeds, you need about four times as many veins as you do arteries. Not sure if I got that exactly right. Is he right about this and does this support the argument that veins are much more important than previously thought?
what goes in must come out. if it goes in faster than it comes out, then there need to be more vessels taking it out, or they have to be of bigger cross sectional diameter ....its like you kitchen faucet: it enters the sink really fast, but it goes out slower....thus the larger drain
* If carotid stenting testing was originally done with less-than-optimal techniques and therefore not proven as strongly as it later was, how did this affect the implementation of carotid stenting? Did it still get put into practice fairly quickly or was it slower than it could have been? We might've talked about this before, I can't fully remember.
we have spoken about this. The original carotid stenting that was approved by CMS required that a vascular surgeon certify that the patient was not a candidate for surgery. Carotid stenting was relegated to secondary status of limited use because the initial trials showed that percutaneous stenting had more risks than open surgery. Some of the initial trials compard surgery done by experts against stenting done by people who had done as few as four cases. self defeating prophesy.
Now, as the next generation of trials is done comparing experienced operators of both methods, stenting is shown to have fewer complications.
Sound familiar? Lets wait on the RCTs
I have more, but maybe that is enough for now....
Glad you're back, can't thank you enough for what you're doing to move CCSVI forward for all of us.
you aint seen nothin yet