This Is MS Multiple Sclerosis Community: Knowledge & Support

things are really busier. i have to create a website, write some text, etc
but i have been waiting to see the MRV before showing this very interesting case study

So when Cece states you "used an 18mm balloon" on her RIJV, that means in a valve within that vein, only the valve, correct? And you determined the size by using IVUS to measure a "good" segment of that vein.

So, the stenoses of the vein does not mean a structural narrowing of the vein, it just gets less blood flow due to a narrow valve (narrow annulus or leaflet problems) and is this why it gets narrower? So if I solve the valve problem the narrowing of the vein will disappear? So this way, my purpose should be not to dilate and harm the vein walls only treat the valves?

Are there cases when there is stenoses without valve problems? I guess then the vein has not developped properly and I must stretch the vein wall; however, I do not know how successful that would be?

Can scar tissue be the original cause of stenoses or is it a problem only after the operation?



Can scar tissue goes away by time? Does it get healed or stays there for ever?

I had valve problems on both sides. It was the valve that was ballooned, I should've said that more clearly.

And please let us know how it looks. Worrying....
(You know too that any IR can do a ultrasound check for a clot, it does not have to be a CCSVI IR.)

Another quick (and perhaps not helpful) question if I may Doctor: what is the actual status of synthetic blood? It might includes all the needs and benefits of natural blood while the veins/constrictions/stents/clots/whatever cures or get fixed/waived/straight; then we fill up again with the natural blood we stored??

Or something like that?

How would you interpret this image, from Dr. Zamboni's published endovascular treatment study? Is there a possibility that what's seen in (A) could be phasic? Even if it's phasic, would the reflux still be harmful?



Anyone out there with a candy wrapper stenosis image who cares to post? Bonus pts if you know what phase of respiration it was imaged in....

drsclafani wrote:
newlywed4ever wrote:
How concerned should I be? I have my 3 mo. f/u with Dr Makris 5/3/11... thanks!


get a simple compression ultrasound to look for blood clot now.

And please let us know how it looks. Worrying....
(You know too that any IR can do a ultrasound check for a clot, it does not have to be a CCSVI IR.)

Thanks, Cece. I do know that I don't need the Zamboni ccsvi protocol but, good god, I can't seem to convey this to the local doc & her nurses. My GP has called AAC and is awaiting a call back. In the meantime, I am assuring the nurses that I'm not going to have a heart attack and they don't seem to have a clue what internal jugulars are...I love living in a rural area EXCEPT when it comes to medical issues...

yes and no. Sometimes the vein above the obstruction dilates.If you measure that part you end up dilating larger than the area of obstruction. no, i measure the diameter of the veinwhere the valve is stenosed.

the balloon is larger than the valve sometimes so there is n aturally going to be inflation of the balloon in normal vein. The trick is to minimize the stretch of the normal vein while adequately dilating the narrowed valvular area.

simple, eh?

the xray dye has to go through the valvular area. since the valvular area is narrowed, the xray dye column also gets narrowed. it looks like a stenosis caused by scar, caused by arteriosclerosis of an artery.....but the cause is so different.




that is the goal




there are also stenoses due to fibrosis and hypoplasia. we do not have data but i suspect that it might require more frequent dilatation.....but this is too premature. we are still attaining understanding of the nature of the stenosis.

and this is my theory based upon my interpretation of ivus....i am sticking my neck out

you can get scar tissue from an infection or other inflammation. you can get scar from trauma, catheterization, angioplasty

scar is not likely to go away.

Dr. Sclafani, what do you make of this? Needless to say most CCSVI'ers are taking lots of D3.

http://onlinelibrary.wiley.com/doi/10.1 ... 0/abstract

Update: got the simple compression ultrasound (although it was not "simple" to do so in Michigan's U.P.) and no blood clot was found - hurray! I am told it looks like a swollen lymph gland. Thanks Dr S and everyone else!

it is unclear why they exceed dr zamboni's criteria for ccsvi. they want more than two criteria. Most of us consider more than one criteria to be diagnostic of ccsvi.

hmmm

They list infection of the puncture site as a possible complication rate. Where did that come from? the Kahn editorial?

i havent found reports of infection of the puncture site in the literature.

hmmmm


they do not mention the name or qualification of a treating physician

hmmm

called today. spoke to a non-physician. they never called me back

so relieved that this was a swollen gland..do you have a sore throat?

glad it wasnt a thrombus. so far no thrombi with new protocol of sizing balloons....a sigh of hopeful relief