DrSclafani answers some questions

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 6:48 am

newlywed4ever wrote:I was tempted to see if Dr Arata could get through my occluded LIJV and am ever grateful for this thread. I'm still looking for answers but will wait for the Dr. Sclafani "stamp of approval" before pursuing new avenues....


please, i am not the "know-all of ccsvi or ms". I am happy to give general opinions and share my "knowledge" .

However, it is important to seek advice from your own physicians.
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Advertisement

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 6:52 am

NZer1 wrote:Dr S is there any way of knowing if atherosclerosis is present in the patients you treat?

You didn't answer my question about the ET-1 awareness by IR's, btw?

Nigel, i cannot speak to awareness of ET-1 by IRs. I dont speak for all of them, do not know most of them nor their knowledge base.
NZer1 wrote:I ponder that if MS patients have a 224% higher level than 'normals' then it may have involvement in outcomes of PTA because ET-1 is linked to atherosclerosis, is there an influence on things like re-stenosis incidence?

Nigel




Stenosis or restenosis of these veins is not caused by atherosclerosis. There is no evidence that atherosclerosis plays a part in ccsvi.

atherosclerosis is genereally associated with arterial disease.
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 6:55 am

NZer1 wrote:Dr S is there any way of knowing if atherosclerosis is present in the patients you treat?



Nigel

the overwhelming number of patients i treat for ccsvi do not have any evidence to atherosclerosis. Hypertension in uncommon, prior myocardial disease history is present in less than 1%, Kidney failure due to atherosclerosis has never been present, no patients have peripheral arterial disease symptoms
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:01 am

NZer1 wrote:Dr S, Hi, me again!

If ET-1 is crossing the BBB because of 'Franz Schelling' back jets, or Rosa alignment issues or Zamboni CCSVI reflux and travelling through the brain GM and WM lesions and mixing with the CSF and spreading through the brain with the concentration of ET-1 is increasing, will that cause symptoms and atrophy and things like Thalamas link issues.

Could be a cascade of issues?

A host of disease types could have this mechanism and that could be the reason for similar symptoms across many de-generative diseases?

It might also explain why PTA outcomes vary because of the ET-1 levels that either do or don't cross the BBB post PTA, a sealing effect?

Back to bed too much thinking ;)
Nigel

Nigel, it is a big jump from a chemical number to all your hypotheses listed above. for all we know, elevated ET-1 may result from MS, or venous flow problems rather than ET-1 be the cause of MS, etc.

Unfortunately, it requires time and many dedicated scientists to unravel all these bits of information. I love your thinking but in fairness to all reading, it might confuse patients for me to render opinions on hypotheticals.
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:23 am

JohnAm wrote:Dr S,

An acquaintance attended a seminar at the local university hospital last month and the dr/researcher cardiologist talked about NIRS as a new technique or modality in addition to IVUS.
Could NIRS be of value in your work and CCSVI armamentarium?


-

JohnAm, interesting question. NIRS stands for a few things, including
nuclear information and resource system, a group dedicated to reduction in radiation exposure. the answer is yes, any radation exposure reductino is of value to us
2. National Institute on Retirement Security. The answer is yes, at least to me, as i am now more than 65 years of age
3. Near InfraRed Spectroscopy,, the answer is yes. The main imaging technique using NIRS is optical coherence tomography (OCT). This imaging technique captures and measures optical light scatter within tissue. Resolution is very high, and can be less than a micron. However it is a surface imager as it does not penetrate more than a few millimeters into the tissue. It has mainly been used for analysis by imaging of the eye, notably the retina. It has recently been used in a manner similar to IVUS in studying the surface of coronary arteries and to look for lipid rich plaques in arteries. . I investigated possible use in my patients last year. Unfortunately, the device currently available is for small arteries such as coronary arteries which are only a few millimeters in diameter. It may well allow better visualization of the surface of thin structures such as valves, but the field of view currently available would not allow good visualization of the large veins we look at in ccsvi.

The higher resolution new IVUS currently undergoing investigation under FDA supervision would provide the higher resolution that might be beneficial in evaluating the veins of ccsvi.. At the current time, neither method is currently practical for us
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:24 am

CureOrBust wrote:
drsclafani wrote:i gave a talk on early restenosis and "non-responders" and how to address the many causes of these.
oooo.. i'd be very interested in this video.


i am no expert in creating videos by myself. Give me some time to figure it out
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:44 am

Cece wrote:
CureOrBust wrote:
drsclafani wrote:i gave a talk on early restenosis and "non-responders" and how to address the many causes of these.
oooo.. i'd be very interested in this video.

With nonresponders in quotations, I think this is probably not about true nonresponders who had the procedure done to perfection but didn't result in any change in their symptoms. Instead it would be patients who seem to be nonresponders but whose procedure wasn't thorough enough or the balloons not appropriately sized and so there is hope for a more optimized procedure to turn them into responders.


Cece: lets not assume what i mean. There are many patients who seem to have a response that is very short lived. Many consider this a placebo effect and consider these patients Nonresponders. Let me get this lecture into a form that clarifies such issues of semantics and then we can discuss it.
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:46 am

NZer1 wrote:
Dr S I think you could possibly interest BNAC with a video and training, they seem to struggle with the issue of undertreating and then blame! ;)

;)
Nigel



my lack of response to your comments should not suggest any implied opinion about these colleagues for whom I have much admiration.
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:50 am

munchkin wrote:Hi Dr. S

Is it possible for veins to diminish in size due to low/slow flow? If this does happen will altering the flow result in a return to the normal size?

Thanks for your help.


ABSOLUTELY

Veins are passive compliant vessels. Their size depends primarly on the amount of flow within them. Ever notice how the veins of your hand are larger when you hand is below your heart than when you have it above your head?

The cerebrospinal venous drainage has two major outlets, the internal jugular veins and the vertebral plexus and emissary veins. Your veins tend to distend when you are lying down and collapse when you are standing.

In many circumstances venous distension occurs in collapsed veins after relieving obstructions
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 7:52 am

ok, i am caught up. If there are questions that i have missed, please re-question me

for the moment I am going back to preparing my lecture and answering my patients' emails on my "day off"
DrS
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby Robnl » Wed Apr 24, 2013 9:48 am

drsclafani wrote:ok, i am caught up. If there are questions that i have missed, please re-question me

for the moment I am going back to preparing my lecture and answering my patients' emails on my "day off"
DrS


Well, if you ask for questions.... :lol:

No questions over here, just want to let you i'm busy trying to contact à vascular surgeon over here.....no fasttrack 8)

Rgds

Robert
User avatar
Robnl
Family Elder
 
Posts: 439
Joined: Sun Nov 08, 2009 3:00 pm

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 11:19 am

Robnl wrote:
drsclafani wrote:ok, i am caught up. If there are questions that i have missed, please re-question me

for the moment I am going back to preparing my lecture and answering my patients' emails on my "day off"
DrS


Well, if you ask for questions.... :lol:

No questions over here, just want to let you i'm busy trying to contact à vascular surgeon over here.....no fasttrack 8)

Rgds

Robert

hope you are doing well
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby newlywed4ever » Wed Apr 24, 2013 11:32 am

drsclafani wrote:
newlywed4ever wrote:I was tempted to see if Dr Arata could get through my occluded LIJV and am ever grateful for this thread. I'm still looking for answers but will wait for the Dr. Sclafani "stamp of approval" before pursuing new avenues....


please, i am not the "know-all of ccsvi or ms". I am happy to give general opinions and share my "knowledge" .

However, it is important to seek advice from your own physicians.


I understand. I had been reading about Dr Arata and am still hoping to find something to get through that occluded LIJV but wasn't entirely confident in his theory. I did not mean to imply that you are steering me away from any thing or any one. I still consider you my CCSVI physician and hero.
newlywed4ever
Family Elder
 
Posts: 255
Joined: Thu Apr 17, 2008 2:00 pm
Location: Michigan

Re: DrSclafani answers some questions

Postby drsclafani » Wed Apr 24, 2013 11:38 am

newlywed4ever wrote:
drsclafani wrote:
newlywed4ever wrote:I was tempted to see if Dr Arata could get through my occluded LIJV and am ever grateful for this thread. I'm still looking for answers but will wait for the Dr. Sclafani "stamp of approval" before pursuing new avenues....


please, i am not the "know-all of ccsvi or ms". I am happy to give general opinions and share my "knowledge" .

However, it is important to seek advice from your own physicians.


I understand. I had been reading about Dr Arata and am still hoping to find something to get through that occluded LIJV but wasn't entirely confident in his theory. I did not mean to imply that you are steering me away from any thing or any one. I still consider you my CCSVI physician and hero.


email me at ccsviliberation@gmail.com if you want a specific answer to a specific problem. i cannot do that on tims
s
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com
User avatar
drsclafani
Family Elder
 
Posts: 3147
Joined: Fri Mar 12, 2010 3:00 pm
Location: Brooklyn, New York

Re: DrSclafani answers some questions

Postby Robnl » Fri May 03, 2013 10:32 am

Hi doc,

I came across something that is called...Superior Vena Cavography and Azygography....

http://radiology.rsna.org/content/88/3/441.extract

What is it?

Rgds,

Robert
User avatar
Robnl
Family Elder
 
Posts: 439
Joined: Sun Nov 08, 2009 3:00 pm

PreviousNext

Return to Chronic Cerebrospinal Venous Insufficiency (CCSVI)

 


  • Related topics
    Replies
    Views
    Last post

Who is online

Users browsing this forum: No registered users


Contact us | Terms of Service