bruce123 wrote:drsclafani wrote:Thank you for your kind words of appreciation. It means a lot to me. Preparing those cases takes upward of two hours to do. When few questions arise, i wonder whether it is valuable to patients.
I don't post on this thread because I don't know enough to ask an intelligent question, but I ALWAYS read this thread. I continue to learn so much. Thank you Dr. S.
Good luck with you meeting in Toronto with the Canadian MS Society.
http://www.thisisms.com/ftopicp-162666-.html#162666drsclafani wrote:Cece wrote:drsclafani wrote:
Dr. Siskin used the fact that iliac disease was not found in MS patients to any higher degree than the the incidence in the regular population as justification for not interrogating the iliac. (see ccsvi.org video for his discussion of this)
I imagine the same argument might be applied for whether or not to look at the renal vein, especially if something is only found about once every 75 - 100 patients. I'd disagree with such an argument, of course.
i think that dr siskin missed the point. We do not look for may thurner syndrome in ccsvi because it is more frequent in patients with ccsvi; we look for it because its presence is hemodynamically more significant in patients with ccsvi. This was the point that Robbie galeotti brought home to me.
I have to agree with you.
Below is a post I placed on April 27 in answer to Dr. Hewett presentation on the same subject.Nunzio wrote:joge wrote:In this video with dr. Hewett, he explains (stenting in) MTS. Also he shows MTS is found in 17% of his (160) ccsvi patients (at 8 min, 30 sec).
In a normal (asymptomatic) population it is found in 6 -24%.
http://www.youtube.com/watch?v=A_R88CJT ... re=related
So.... Dr. Hewett is totally missing the point.
In CCSVI patients we are not treating May-Thurner to help the leg, we are treating it because it diverts the blood that should drain through the Inf Vena Cava, into the Azygous vein and overloading it.
I do not expect MTS to be any higher in MS than in normal population.
Still if I have CCSVI, specially with Azygous problem, I would not want to have an additional condition that would interfere with my Central Nervous System circulation
That is why Dr. Zamboni and Dr. Sclafani always enter on the left side and check the left Ilac and renal vein.
drsclafani wrote:I sometimes find the left renal vein catheterization very difficult. the vein has a very wide mouth and the vector of pushing the catheter makes it difficult to keep the catheter into the vein
I have not spent a lot of time getting into the vessel and have been too quick to stop.
I cannot agree with galeotti on this. I h ave done over 1000 inferior vena cava filters. In preparation for placing the filter, i have catheterized about 1000 renal veins and rarely seen this entity. Perhaps it is an association with ccsvi.
drsclafani wrote:I have been looking at these IVUS for a long time. When i first saw those bright dots and blotches, i wondered whether they were real. I am now convinced that I can see webs. before i wasnt sure and i left them alone. Now i am considering angioplasty of the webs
Cece wrote:Back on page one of this thread, I was asking if the high-up jugular stenoses were in the brain (they're not) and how the catheter is able to get to the jugulars from the femoral vein without going through the heart (umm, it goes through the heart).
Why settle for not knowing when there is someone here eager to teach?
Perhaps anyone who thinks they do not know enough to ask a good question might feel obligated to ask a question on the next case...let Dr. Sclafani judge whether it is good or not....
drsclafani wrote:Let me say it again... ...
THE ONLY BAD QUESTION IS ONE THAT IS NEVER ASKED
PCakes wrote:drsclafani wrote:Let me say it again... ...
THE ONLY BAD QUESTION IS ONE THAT IS NEVER ASKED
Okay, here goes.. Dr Sclafani do you think that thyroid issues, very common in MS, might be tied to CCSVI?
My oldest sister, not diagnosed with MS but with many many connective tissue disease issues, called today to tell me that she has tested positive for both Graves and Hashimoto's. Hypo and hyper thyroid? She is being told the only way to deal with this would be to pharmaceutically 'kill' the thyroid. I am very worried for her.
Kleiner wrote:To reiterate what the last few posters have said, I don't ask a lot of questions, as I do not have the in depth knowledge, but I have read all of the 5000+ posts on this thread and they have been more helpful than you can imagine. So helpful that I know I am making the right decision to visit you whenever I can get some support up here in Canada. You truly are an amazing person for everything that you are doing.
That being said, what would you say about strapping that IVUS machine to your back and opening up a few veins while you are visiting Canada?? Maybe a cross Canada Venoplasty Tour...
Robnl wrote:Hi doc,
Question; some time ago yoiu mentioned that you find a lot more azygous problems when you look at this vein under different angles. You said '25% percent and rising'...how are the numbers at this moment?
Keep up the good work...Dr. S. the explorer
Thekla wrote:You mention not treating/placing a stent in the renal vein because the necessary tests hadn't been done. With a positive outcome when you do treat this patient, would anticipatory testing be a good idea across the board for patients, or perhaps repeat patients? Or is this too rare to warrant it?
I love reading the cases you post here even though I seldom post any questions---I'm glad Cece does! I too have trouble seeing the details on the ivus, but I never was any good at seeing whether those baby ultrasounds had a penis or not! I was surprised by both of my boys!
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