This Is MS Multiple Sclerosis Community: Knowledge & Support

sorry i missed your question.

i think that normal valves are almost impossible to see. only thick, immobile valves are visible.

i thought about going into more detail, but held off because it is unclear whether ONLY obstructions can cause ccsvi. If there is absence of the valve there should be some problems with reflux. While this reflux between heart and jugular would occur, it is not clear whether it will cause ccsvi because there is easier relief from the reflux, although transient global amnesia is reported with jugular valve incompetency

very confusing, that is why i wanted to avoid this

I know. I havent got a good answer yet

Dr.Sclafani

Understanding that the technology is still being tested on arteries do you think the dissolving stents may be of use to those of us who might be in need of stents?

Is there a difference in the structure of scar tissue if it is from actual damage to the vein or if it is intimal hyperplasia? Does this affect your decision on implanting a stent?

Thank you for all of the information you share with us.

Kim

If such a patient made it to you, they would likely have an MS diagnosis. And they would show up as having reflux on the doppler ultrasound, just as patients may show up as having reflux on follow-up ultrasounds after the valves are ballooned.

I would suspect that this sort of absence-of-the-valve reflux would only contribute to CCSVI if there were other CCSVI abnormalities present in the vein or other veins. When you mention easier relief, it would suggest that reflux and venous congestion are needed, not reflux alone.

This is also the condition we may be left with after being treated for CCSVI, if the valves are obliterated. In my experience, this condition is far preferable to the condition I was in before my procedures.

Ok, we can avoid this conversation now.

Dr. S my guess is that focusing on a smaller area of lesion incidence such as the cervical spine would give more tangible info to expand on, and transfer the learning to other regions of the brain.
With the flow system in the area it is less confusing when changing variables with treatment in many systems as you know.
My assumption is that the primary blood flow is easier to assess and the areas that need to be flow tested are more defined. The other challenge is that there is CSF flows and function as well that could be 'causing' lesions. This is likely a multi-disciplinary task because of the function assessments and electrical as well as plumbing involved.

*Is this where Paulo is heading with his interest in the verts and Lumbars?

*Can the cervical flows be accurately assessed and have they been compared to normals?

I will have a look at what Dr Schelling had to say on spinal lesions.

My personal focus is this area because of my own MRI results, and of course when a skilled and trusted Dr. gets to look at my tubes I am wanting to know that that area of dysfunction is under the scope.
Dr Flanagan has just linked into a group using Upright MRI to focus on this region as well, so I would imagine this will produce some insights soon.
Ok back to work,
Regards Nigel

nhe

here is the answer from the manufacturer's engineers



I hope that this answers your question.

Just popping in and waving hi to Dr. Sclafani ((((waving)))) Hope you are doing well and taking time for YOU!

_________________
Boyfriend dx'd 6-6-06!!! RRMS............CCSVI procedure done on Nov. 13, 2010 and March 7, 2011 by Dr. Sclafani!

dissolving stents are not the issue. Stents have some inherent problems. like thrombosis and in-stent intimal hyperplasia. Will a dissolving stent obviate these, or will a drug eluting stent do the job. or other maneuvers.

I think that we know the problem, it is the solution that is taking a long time. The big problem is that the majority of devices are tested in the coronary arteries since these get the most play, and revenue. The coronary arteries are much much smaller than the jugular veins. So, once things are proven with small vessels, we need to develop their use for large veins.

But yes, perhaps they will help.


Intimal hyperplasia usually is associated with stenting, more than angioplasty alone. Both can lead to resistant stenoses. although scar tissue is usually more problematic for dilatation. Intimal hyperplasia seems to dilate much better but, unless you stop the intimal hyperplasia, stenosis keeps recurring despite your best intentions or manuevers.

i think it is reflux and stenosis that is the problem

I don't understand all of this but I think it's excellent of you to have gone to that length for the answer. What amused me was the line, "If there is more detail required (for instance research paper, etc.)" because you can substitute in 'social media forum' in the 'etc.' We do like all the details here.

Hope your week is going well!

Seeing the comment about scar tissue reminds me.
If a person had been over ballooned would this be evident and obvious, I see that when scar tissue is present it creates more problem for you.
There was a time when large balloons were touted as being the best option for busting valves, I guess there is poetic license with the term 'large'. I remember watching Dr. Tarqins videos, thinking that the idea of 'big is good' is risky without knowing what the vein can cope with before damage occurs that will be problematic in future.

Is it possible the vein wall is 'diseased' and that that will also allow the BBB breach that is spoken of, the area would need to be within the skull I guess, so it would not be from PTA?

It is the term 'diseased' that I am interested in and how to identify it, and where it is found and why?

Is the vein wall the problem when over ballooned or is it the remains of the valve and anulus that remain present the problem?

Is it possible to identify when there is scar tissue? IVIS?

and how do you know when there is vein disease?

Thanks again,
Nigel

Hi Doc,

see
http://iamsickofms.blogspot.com/2011/08 ... swers.html

Globally, i'm in the same situation as Ginger.....i'm going to check the leg veins.

What do you think about ccsvi in 'other' places??

mike
do you have the image yet?

Dr. Sclafani,
Thanks so much for sharing that information. I recall reading about pullback speed and the image stacks in the IVUS Made Easy book, but had forgotten the details. The book is now back at its home library 2270 miles away. The dimmensions quoted above at 74-170 µm help to put images such as this into perspective. In effect, although it appears that we're looking down at the valve, we're really looking at a cross section through the valve.

Thanks again, NHE