DrSclafani answers some questions

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby msjen » Thu Feb 10, 2011 7:38 am

I am having some trouble understanding some of this...
Is it possible to only have reflux? It seems as though the valves are responsible for this and if not properly addressed could cause an unsuccessful procedure? Any thoughts?
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Postby Donnchadh » Thu Feb 10, 2011 3:22 pm

Dr. Sclafani:

You previously posted some images of what a stenosis actually looks like (from a cadaver). However these images are no longer available. Would you please re-post them as I wish to have something to show others?

Thanks!

Donnchadh
Kitty says, "Take that, you stenosis!"

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Postby drsclafani » Thu Feb 10, 2011 7:41 pm

msjen wrote:I am having some trouble understanding some of this...
Is it possible to only have reflux? It seems as though the valves are responsible for this and if not properly addressed could cause an unsuccessful procedure? Any thoughts?


IT IS ACTUALLY SIMPLE

REFLUX is a manifestation of ccsvi
VALVULAR OBSTRUCTION, the most common form of obstruction, is a cause of ccsvi
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Postby drsclafani » Thu Feb 10, 2011 7:41 pm

Donnchadh wrote:Dr. Sclafani:

You previously posted some images of what a stenosis actually looks like (from a cadaver). However these images are no longer available. Would you please re-post them as I wish to have something to show others?

Thanks!

Donnchadh


why are they no longer available. i didnt remove them. perhaps the owner did
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Postby Donnchadh » Fri Feb 11, 2011 8:06 am

drsclafani wrote:
Donnchadh wrote:Dr. Sclafani:

You previously posted some images of what a stenosis actually looks like (from a cadaver). However these images are no longer available. Would you please re-post them as I wish to have something to show others?

Thanks!

Donnchadh


why are they no longer available. i didnt remove them. perhaps the owner did


On page 260, where the images used to be, there is now a white square.
Inside it, "This photo is currently unavailable" and "FLICKR."

Any other stenoisis images available?

Donnchadh
Kitty says, "Take that, you stenosis!"

Got MS?.....Get Liberated!
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Postby Cece » Fri Feb 11, 2011 10:01 am

drsclafani wrote:
Donnchadh wrote:Dr. Sclafani:

You previously posted some images of what a stenosis actually looks like (from a cadaver). However these images are no longer available. Would you please re-post them as I wish to have something to show others?

Thanks!

Donnchadh


why are they no longer available. i didnt remove them. perhaps the owner did

If the cadaver removed the images, we have even bigger problems!!

Do not worry, I have watched The Walking Dead, I know what to do.

The missing images have been a concern for a month now, I've gotten pm's asking if I know why they are gone. It is more than just the ones donnchadh mentioned. Hope they can be found, this thread is quite a resource.
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work around

Postby hwebb » Fri Feb 11, 2011 3:13 pm

If I see a useful picture in this thread...I literally take a screenshot and store it myself. Am scared the image will disappear from the thread.
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Postby drsclafani » Fri Feb 11, 2011 9:41 pm

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thank you all so much

i have received a few awards and a few accolades in my life. Your gift today was humbling, exciting, touching and unforgettable.

i cannot wait to share with my loved ones


sal
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Postby brave » Sat Feb 12, 2011 1:52 am

Hello Dr Sclafani
I had my CCSVI procedure done at Albany on 11/24/10

looking at my ultrasound result (before procedure), I see that I met criteria #1 and result was negative for other 4 tests

criteria #1: Gray-Scale abnormalities of the proximal internal jugular veins. This is positive when valve
abnormalities, flaps or membranes are identified within the lumen of the internal jugular vein

Finding: positive on the right , positive on the left


and looking at ultrasound result (after procedure), I see that result for criteria #1 is negative but strangely criteria #4 changed to positive after my procedure

criteria #4: Reflux in the internal jugular and/or vertebral veins in the spine (0 degrees) and upright (90 degrees)position. This is positive when flow reversal is identified in both positions on Doppler imaging for > 1.5 seconds

findings: Negative on the right and positive on the left side with 504 ms degree of reflux
in the distal left internal jugular vein

I would like to ask you, what could be the reason that criteria #4 changed to positive after CCSVI procedure?

also my left foot has swollen badly since 12/25 (ultrasound hasn't shown any blood clot) , could this swallow being developed as result of issue mentioned in criteria #4

and last not the least
Do you see me a candidate for second CCSVI procedure with you(need to mention that so far I haven't had noticable improvement after my CCSVI on 11/24

Thanks in advance,
brave
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Postby NZer1 » Sat Feb 12, 2011 12:20 pm

Hi Dr. a couple of questions have been rolling around.
I have noticed some IR's use the term lesions in the veins, this to me seems odd as though there is some sort of cross over in terminology regarding MRI lesions and valve malformations, are you able to shed any light on this?
The second thing is that I am wondering if some of the less experienced or less read IR's are aware of what the restrictions in veins are in some cases. It is the way that they have treated the restriction, as thought it is simply a compression of a vein rather than a valve issue such as reversal. The need for treating re-stenosis is the reason for my pondering.
Hope you have a successful day with ecstatic patients.
Regards Nigel
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Postby elliberato » Sat Feb 12, 2011 5:15 pm

Dr S,
i applaud your dedication and am excited to see the findings you will provoke through your procedures. Could you be so kind to share some of them.? Have you seen some major improvements thus far? Anyone walking tha wasnt or spasm relief or heat intolerance relief or the like?
thanks in advanc
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Postby Liberation » Sun Feb 13, 2011 3:46 am

Dear dr Sclafani,

Just a few questions that popped into my mind:

1.) Am I right if I think that those veins should be implicated in theory in the disease which are draining the blood from that part of the spinal cord which has laesios?

2.) Do IJVs drain blood only from the brain and the cerical spine?

3.) Can it be categorized which veins are most likely to be obstructed based on the locations of the laesios in the spinal cord or the brain?

4.) As I have PPMS and laesios in my spinal cord besides the ones in my brain, I would have assumed that the azygos or other veins are also obstructed in addition to the IJV. However, my doctor told me that he is almost sure that the restenosis of the IJV should be the culprit in the continuing deterioration in my condition. The restenosis was proven by ultrasound. Could it be?
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Postby sara-sama » Sun Feb 13, 2011 9:54 am

Donnchadh wrote:Dr. Sclafani:

You previously posted some images of what a stenosis actually looks like (from a cadaver). However these images are no longer available. Would you please re-post them as I wish to have something to show others?

Thanks!

Donnchadh


Image
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Postby sara-sama » Sun Feb 13, 2011 9:57 am

Donnchadh wrote:Dr. Sclafani:

You previously posted some images of what a stenosis actually looks like (from a cadaver). However these images are no longer available. Would you please re-post them as I wish to have something to show others?

Thanks!

Donnchadh


http://www.freeimagehosting.net/uploads/ff6d207b47.jpg
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Re: Treating Siblings

Postby girlgeek33 » Sun Feb 13, 2011 11:03 am

drsclafani wrote:
i have not treated any siblings at this point. I am working up a mother daughter pair and have treated the mother. I doubt that they will have mirror image findings because they are so different in age. Their clinical presentations are also different.

but we will see.


I'm still looking to have my daughter's veins looked at. Haven't discussed in some time, so to refresh, she has been going through a dx process and to date still undx. Her symptoms are very similar to MS, yet spine & brain MRI do not warrant an MS dx. She is following the trail her docs are leading her on, and the latest is a gastro doc that doesn't think she has anything wrong, that it is in her head. Sound familiar MSers? She is only 21. I don't know what my brain scans would have looked like back at that age, but I can trace my symptoms back to about 20. Knowing what we do about CCSVI, I wonder if this is the early signs of CCSVI on her cerebral vascular system. But, because she is not already dx with MS, nobody will even do a doppler. This has been undx since she was 14, with worsening at about age 20 to bring us back to the doctors. As a mother, I want to avoid her ever getting MS. I realize we are at the early stages of CCSVI understanding. At what point will anyone look at veins of a patient like my daughter? Time is brain after all...
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