NHE wrote:fogdweller wrote:drsclafani wrote:drbart wrote:Hi Dr S,
Is it feasible to replace a long, thin IJV that has a long, thin (8x80!!) stent?
I see articles on bovine replacements.. has this work progressed to be useful to humans?
yes it could be done. the problem is the durability of those stents.
I have some questions about stents in veins. Is there any history of stents collapsing/cracking/squezzing patially shut in veins? Is a series of short stents back-to-back sometimes used instead of a long stent?
I posted a link to a pdf a while back which discussed stent fracture in the superficial femorial artery (SFA).
There are some photos of fractured stents that I think everyone contemplating stents should take into consideration. Essentially, the longer the stent the greater the risk of fracture and complications. However, there was still a high rate of fracture even with the shorter stents in this study. Moreover, the jugular veins being located in the neck likely experience a great deal of torsional and compression/extension movement as the head is turned side-to-side and up and down respectively. Such stress would increase the chances of fracture.
Nunzio wrote:Hi Dr.Sclafani,
I had a venogram done recently. My Azygous vein was called normal.
This is the picture.
to me there might be a possible narrowing at the beginning of the arch, to the left of the words I typed. Since I have PPMS this would be in agreement with Zamboni findings in those patients.
Please let me know what you think.
Thanks a lot.
Cece wrote:Nunzio, I can really see that one too...great teaching example but greater if you can go get that fixed.
NINOU wrote:Dr Sclafani,
i coming back with more informations.
I made in France several exams with following conclusions :
Doppler protocol Zamboni :
Diagnose CCSVI with two criterias :
Left jugular internal: no flow and refluxes in valsalva, but no stricture
Left jugular right : high flowrate
Vertebral left : high flow
Vertebral right : normal
The superior longitudinal veinous sinus drains almost entirely into the right lateral sinus.
The jugular foramen 73 mm2 right, left 36 mm2.
Size asymmetry of the jugular veins, the left jugular vein has an axial surface at least 15 mm2
The maximum size of the left jugular vein 95 mm2.
This asymmetry of size seems to be related to the size asymmetry of lateral venous sinus, although the recess between the C2 of the styloid process has a low antero-posterior diameter (4 mm).
The venous vascular exploration of the neck size of the asymmetry found in appearance congenital sinus venous side with a predominance of right side.
It still looks laminate the left jugular vein high in its course without real retro-styloid extrinsic compression or intraluminal signal abnormality.
I got the following answer from a doctor (the only one making some CCSVI interventions in France) : "sorry, we can do nothing, too risky ..."
I am lost, sad and disappointed. What do you think ? is it possible to do something or to find in my brain from where is coming the problem ? With which kind of exam ?
Many thanks for your advices
NZer1 wrote:Dr.S is elastic recoil the same as the annulus returning to its normal size, generally speaking it would not have been popped?
Is the position in the vein of the inverted/problematic valves similar in most cases or are these valves basically any where in the jugs for instance (malformed and mal-placed)?
yes, but finding a balloon that is good to do that has eluded meIs ballooning and looking for waists progressively along the vein an option,
(it seems that there are going to be difficulties finding the problem areas in the veins on the more frequent treatments especially where conservative early days treatment has been performed)?
Is it true that many of the treatments done conservatively (ballooned) will likely need to be re-visited?
There are quite a few examples in Australia and New Zealand where benefit reverted quite quickly, I believe these would today be approached differently.
This in my mind is going to help with understanding the stats of improvement from treatment because of the new understanding of the required sizes and pressures for ballooning. Doesn't help the financial wellbeing but increases HOPE again.
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