Dear Dr S,
Many thanks for The Symposium a week ago!
Another technical question, I don't think it has been much discussed so far:
- What pressure is being applied to the balloons - are there different cathegories of baloons based on pressure?
- I understood the applied balloons are hydraulic inflated, using a contrast dye in the liquid media for good visibility of balloon shape. Are there pneumatic driven, i.e. gas inflated ballons used as well?
- How is the pressure applied? Manually, with a pressure indicator you need to watch (possibly with a pressure limiter you can set), or by means of a device automatically controling the final pressure to reach as well as pressure progression over time, once you put these data in and push "start" button?
- From a symposium video - here my thanks to Girlgeek (<shortened url
>) - I remember your question to Dr Tariq Sinan during his presentation on using ballooning inside the azygous as an 'imaging technique' of the circular narrowings of valve/web, visible by the indentation(s) they cause on the inflated balloon. You have asked him what pressure he applies/records at the balloon, but he did not answered directly in terms of numbers. He talked about using the nominal pressure specific to each balloon (although sometimes stretching it a bit more, as the balloon "won't burst so quickly").
- Can you interprete his answer bit more by now?
- IYO, how destructive could this "balloon imaging"-technique be for healthy, functional valves? I guess one needs at least some functioning valve(s) left in the azygous - is this correct?
- He mentioned that around 95% of patients are having abnormal valves and/or webs in azygous, also distal from the arch - would you estimate be that high ? And, how well do we know how a normal valve here should look like under the available phlebography technique?