Hopeful10 wrote:Dr. S,
I hope you're having a wonderful time in the Adirondacks!
When you get back and have a chance to answer, here are my questions for you (and thank you again for taking so much time to educate and reassure us):
1. Professor Zamboni found almost no restenosis in the azygous veins of the CCSVI patients his group treated (according to the paper published approximately 1 year ago). Based on your experience and discussions with other doctors (or patients of other doctors), are you finding this typical? In other words, if a doctor who is experienced in treating CCSVI performs PTA on a patient's azygous veins, would it be fair for the patient to think that there is a very good chance that his azygous would stay patent for 6 months, 1 year, 18 months, or even longer?
it would be a guess
i will make an educated guess that the incidence of recurrence with azygos will be higher than dr z reported in his study. I cannot see why azygos woulod act much differently from jugular veins that are stretched and dilated.
2. Someone on this website posted a theory that patients whose MS symptoms come, go, and change frequently (even minute-to-minute sometimes) probably have either a periodically sticky flap/membrane or a periodically functioning valve in the internal jugulars that causes reflux sometimes, but not consistently. Do you think this theory make sense?
it is a plausible explanation.
3. Based on your experience and discussions with other doctors (or patients of other doctors), are you finding that fixing flaps, membranes, or valves in the internal jugular has better, worse, or similar success rates (in terms of patency at 3 months, 6 months, 1 year, etc.) to fixing other problems with the internal jugulars? Obviously the only published research is Professor Zamboni's and he didn't publish statistics by type of internal jugular problem. I'm just trying to set appropriate expectations if in fact I have a flap or membrane or valve problem in my internal jugulars -- should I expect that patency at 6 months after PTA will be approximately 50% for these issues, just as Prof. Zamboni reported was the case with internal jugular problems as a whole?
i think that outcomes will be different based upon the type of abnormality or the combinations of abnormalities that are present. but also on anticoagulation profile, the level of disability present, etc