Great conversation, Eric, thank you.
I'd nominate what he did for my procedure as "best practices" although I might also be judging it based on results.
Dr. Sclafani, I have a question, actually, and it is a serious one. I showed signs of MS or CCSVI in childhood. Fatigue, cogfog, some other things as well. Of my three children, my oldest has fatigue. My middle child has fatigue, cogfog, irritability, a poor memory, wakes up at night in hysterics about his legs hurting (been to a specialist and was told it was nothing), and sometimes tells me his neck hurts. He is only five. (My youngest child is not a consideration to this, he is so healthy and active, it shocks me.) I may pursue doppler ultrasound scanning for them, just to know. But at what age would CCSVI treatment begin to be an option? What are the increased risks in venoplasty in a child and at what age might those risks diminish? My son is struggling with all these symptoms.
My thought is that he has to reach adult size first, which would be sometime in his teenage years, but I haven't much to base that assumption on. I would also want CCSVI to be further investigated than it is currently.
first of all, you need to maintain a healthy skepticism.
i think i am moving in a logical direction but i dont have even three months followup on the way I have treated you.
This childhood thing really gets to me. if symptoms are really bad, perhaps treatment is appropriate but first we have to get it right in adults. children are just too vulnerable.
but screening is probably closer. we will need to image cohorts of healthy children first to understand the hemodynamics and then we can image sick children....
what to do with what we find????
we need to be concerned with radiation exposure in the child, more vulnerable than adults to radiation.
we need to understand how the child's veins will react