drsclafani wrote:i am so sorry for your dilemna
Firstly, i would perform ultrasound to evaluate for ccsvi. if positive i would do venography under sedation. if this is not successful, and it probably isnt, i would treat under general anesthesia. if the contract was fixed, even under general anesthesia, I would approach the vein from the left jugular vein from as high up the neck as possible.
After treatment of the left side I would try to cross from the left jugular vein via the left then the right inominate veins into the right jugular vein. and perform treatment of any stenoses on the right side.
Then I would go from the left neck puncture downstream into the azygos vein and continue treatment.
This would be the first time I have done it, but these techniques have been done by others for many reasons.
Can't believe you had an answer to that one! I wasn't sure it would be possible. Phe, I hope you are able to go with Dr. Sclafani or someone else who can treat you in this way. They don't call them innovational radiologists for nothing.