This Is MS Multiple Sclerosis Community: Knowledge & Support

This was posted in the Big Names thread

Hi folks,

i thought that it would be a good idea for a doctor to actually get on this forum and get afeel for what the patients are looking for and what are their worries.

i do perform the liberation procedure myself and am happy to share my thoughts with you.

firstly it took a great mind like Dr. Zamboni to think of the association of the CCSVi in patients with MS. what we ahve found as doctors in our research is that this is more common in patients with MS and we feel that relief of this stenosis may improve the circulation and help relieve the symtoms for a while. our thoughts were confirmed by the series of patients that Dr. Zamboni did and made this a truely liberation therapy.

currently there are only a few of us who perform this and there are plenty of doctors who dont beleive in it but isnt that how most new discoveries are made amidst a atmosphere of ridicule and disapproval , i believe only time will tell us how long the pateints will be in remissions and what is the long term outcome it is too early to condemn the therapy.

regards the use of stents versus just plain balloon angioplasty. as a surgeon i am not averse to the use of stents provided they are used prudently and with absolute indications. just to give you and idea what i mean. the risk of death with balloon angioplasty is less than 1-2% while the risk of death with stents is about 1-2% and may go upto 5% reasons being they need to be anticoagulated as they are in a low flow system and also there is chance of stent migration. In the IJV position this means migrating into the heart and this is fatal. in the azygos system it may be fine to use them as migration is extremely rare. now what if we dont use them then the chance of recurrence is about 40% in 18 months and the risk of a repeat procedure is very low. so it may sometimes be prudent to go that route and low the risk of mortality.

just a few thoughts and hope they spark a healthy question answer session.

regards

rehan

Hello Dr. Rehan,

Are you Dr. Rehan who is associated with Apollo Hospitals?

I really had few questions and I think this is of interest to many here.

Do you do MRV/US/venography on patients or you rely on the scans done by them (either in their country or locally)?

If you do not do scan yourself, do you recommend a place where (for patients in India) where this should be done?

Are you in touch with the Dr. Z or others who have done pioneering work since this is a new area and looks like lot of Dr's and keeping in touch since they cannot do all the research on their own?

Btw, thanks a lot for your thoughts and welcome to TIMS.

Apart from open minded Dr's like you, lot of people here are responsible for making CCSVI somewhat acceptable.

bump