mo_en wrote:Great presentation Dr S!
Dr. Brenda Banwell is doing an ultrasound study on children with MS. If early CCSVI is difficult to trace by venography, i suspect it will be even harder to do with ultrasound. Do you agree?
Actually, i think it may be difficult to see CCSVI in children by all methodologies as i believe that the thickness of the valve leaflets may be too thin. However, i havent studied any children with ultrasound or IVUS.
If nothing is seen, will the conclusion be that ccsvi doesnt exist or that it is not visible?
To the questions:
drsclafani wrote:but becamse exacerbation free while taking natalizumab (tysabri).
Do you think that Tysabri may act by reducing CCSVI severity? It's supposed to prevent T cells from adhering to the vein walls. Could this action be anticoagulant and allow a swift blood flow through the immobile valves?
2. Does blood flow speed influence the way a vein is opacified by contrast media? Is it possible that venograms of problematic veins look normal because blood speed is low and contrast particles have time to surround the valves? Have you noticed (measured?) differences in blood speed between patients and healthy controls?
#1 I do not know of any anticoagulant effects of natalizumab. I am not an MS specialist, but i am a vascular specialist and I would not say that anticoagulants increase speed of blood flow in general.
#2. I have noted decreased flow in patients with ccsvi compared to healthy control, the control being retrospective, namely evaluation of young men sustaining gunshot wounds of the neck, receiving arteriograms that show the venous phase . But more to the point, i have found that the more diminished the flow is, the easier it is to see these stenoses