Wow Dr Sclafani thank you so much! I only just discovered this thread...
I have two questions:
1. My doppler exam in Katowice(A) and Ferrara(B) gave the identical result:(A)"the left internal jugular vein is occluded by pathologic valve in the junction with the brachiocephalic vein"(B) "si evidenzia a carico della vena giugulare sx stenosi a carico della valvola terminale prima dell'ingresso nel tronco comune." I think to have understood from the discussions two doctors had during my doppler that my valve is malformated and floating around in a "floppy" way, obstacling blood flow a bit like an irregular sieve, but not really stopping the flow completely and causing reflux(but I'm not sure). The diagnosis as described above would however suggest occlusion/stenosis...
=> Interesting you said: "If you have resistance to outflow from the brain, you will develop reduction of inflow. Inflow to the brain is a good thing." But I still do not understand, if no reflux (= underlying theory of CCSVI), what could be the damaging impact for MS of such a condition?
Would you think that intervention in this case can bring chances for improvement?
2. I have a similar question as Jak7ham9 below.
jak7ham9 wrote:I get the feeling you think it more prudent to try angio first and then stent which might have higher possibility of complications. Honestly I'd be happy to sign a waiver for the stent but if I have to come back a couple times to get it right if the vein restenosis after angio so be it. I am just happy to get a chance to feel better.
Would be interested in your view on the following strategy:
(FYI, I know my jugular issue, but I still do not know if maybe have azygos problem in addition, since had no MRV yet):
- step1: go to Poland for MRV, venography and if they find stenosis only angioplasty (without stent) as a first step
- step2: monitor potential improvements
- step3A: in case none, well at least I tried
- step3B: should improvements be vanishing after a while, when going for check-up to Poland after 6 months they would detect whether restenosis has occured, and if so, only then go for a stent.
- step3C: should improvements not be vanishing
or only be vanishing in around 1-2 years , get later-on as soon as it's my turn within the 1200
people Bologna/Ferrara waiting list follow-up in Ferrara... although do not know...probably in 3-5 years will unfortunately be more realistic...so might need to go back to Poland or elsewhere....
Thanks so much for your views!