It is a surprising case? Hmm.
Pelopidas, interesting, no real CCSVI symptoms...at least not the 'head' symptoms such as cogfog and disorientation. Weakness could be considered a CCSVI symptom. I suppose the vertebral vein could be doing a good enough job that the brain is drained, thus none of the 'brain' CCSVI symptoms, but then overloading the azygous and vertebral plexus systems, with injury to the spinal cord.
Did the patient have spinal MS lesions or brain lesions or both?
The left and right images appear to show veins that go straight up and down, like a jugular, and the middle image shows a vein that angles in toward the spinal cord, like a vertebral vein. In the right image you can also see the 'puff' of contrast into the subclavian, which looks like the jugular/innominate junction. A check of the continuity of the jugular to the dural sinus will answer the question!
So, we will now perform planned second procedures and necessary repeats within 90 days as part of the initial fee without additional cost except for any stents that are needed. Allows my patient and I to focus on what needs to be done without worrying about unplanned costs
I don't think there's another ccsvi IR out there with a policy like this. There's one that offers half-price on second treatments. This is extremely patient-friendly, and it allows you to do the treatment as you think best. I will be interested in hearing how this affects your treatments going forward. Are there particular presentations of CCSVI that might benefit most from staged treatments? Would a patient who had a less than ideal looking endpoint be brought back for a second staged treatment? This also covers anyone who has a complication from the procedure, such as clotting, or anyone whose veins close up again soon after the procedure? This will also give you more information on the results of your techniques, if you get to see previously treated patients again within 90 days.