brave wrote: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,
Dear Dr. Sclafani,
I also have done my procedure in Albany. My procedure was in October 2010.
After the procedure I still have 3 out of 5 CCSVI criteria as positive.
Like my friend brave I also would like to know if I can have a 2nd chance on this. This time with you.
thanks, flattery will get you everywhere.
This question seems to be coming up frequently.
what are the reasons to have a second procedure?
1. incomplete study
2. equivocal findings
3. missed diagnoses
4. fleeting improvements
5. recurrent symptoms
6. suspicion of thrombosis
7. recurrent CCSVI ultrasound findings?
8. a simple desire to have a second look
9. a mistrust of the first operator
10. feeling worse after the procedure.
if anyone has other ideas, please share them here so we can start to look at why second procedures are done.
Is dissatisfaction with the clinical improvements, or lack thereof, an indication for a second procedure?
what are the ultrasound findings that should go away after treatment?
I would think, (my conjecture) that reflux would be common after angioplasty because the valves are opened by angioplasty. Perhaps reflux can come from the heart toward the brain by an incompetent valve?
can valve thickening be caused by balloon angiopastly?
So i am unclear what happens on the ultrasound after treatment.
The questions about the ultrasound screening are intriguing to me. I intend to ask quite a few questions during the consensus panel discussions on ultrasound at the ISNVD meeting on March 13-15 in Ferrara Italy. they will focus upon the value and interpretation of the postprocedural ultrasound.
On to the question of whether you personally, and your good friend BRAVE should undergo a second treatment by me.
Brave continues to have symptoms and you continue to have ultrasound findings of ccsvi. I guess the most logical thing to do is to have a consultation and a review of yourimaging and interventions to see if there is anything i do differently from the siskin group that might make a difference.
But the answer to your question in the absence of some objective indication like a missed valvef, undersizing balloons, etc is that i dont know