New editorial by Dr. Lorne Brandes

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

New editorial by Dr. Lorne Brandes

Postby cheerleader » Fri May 07, 2010 7:38 am

Treating CCSVI--What can we learn from treating coronary angioplasty?

The history of angioplasty, which was adopted without (gasp) clinical trials-

Believe it or not, Andreas Gruentzig, the “father” of the modern double-lumen balloon catheter to treat clogged arteries, perfected and made his devices on his kitchen table in 1975. After conducting a few animal and human cadaver experiments, he performed his first coronary angioplasty using a “kitchen catheter” on a living person in 1977!

After presenting the results of his first four angioplasty cases at a meeting of the American Heart Association that same year, it is reported that his colleagues burst into applause, recognizing this breakthrough with a standing ovation. Thereafter, Gruentzig travelled the country, teaching his method to scores of other doctors.

Soon, angioplasty was in widespread use without having gone through (up to that time) a proper clinical trial!


link

cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby dlb » Fri May 07, 2010 8:47 am

Very enlightening article - this man gets it & I liked what he said in his last 2 paragraphs as well! Thanks Cheer, for the link.
Last edited by dlb on Sat May 08, 2010 11:38 am, edited 1 time in total.
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Postby Billmeik » Fri May 07, 2010 8:47 am

Am I advocating a return to the past? No. But it is certainly sobering to learn that balloon angioplasty, a highly effective, often life-saving procedure in wide use today, went through considerably less investigation prior to its adoption than Dr. Zamboni’s balloon venoplasty for the treatment of CCSVI… an important consideration for those who argue against treating blocked neck veins without years of further study.




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Postby shye » Sat May 08, 2010 6:38 am

we live in an age of litigation now--this is all about drs needing to protect themselves from malpractice claims...
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Postby eric593 » Sat May 08, 2010 6:59 am

shye wrote:we live in an age of litigation now--this is all about drs needing to protect themselves from malpractice claims...


I think it goes beyond that since meds are often prescribed off-label to patients and they carry some risk and don't have double-blind studies behind them otherwise they wouldn't be considered "off label". Like a lot of medicine, it's sometimes a risk/benefit analysis when there's no clear cut "best" treatment approach. Medicine is practiced in this way all the time. Big pharma only gets slapped on the wrist for it when they use deceptive marketing practices for off-label use.

I don't think this is about a doctor treating a patient and trying innovative ways in an effort to try to work in the patient's best interests. I just can't quite figure out what takes it out of a regular paradigm into something that's experimental requiring oversight. That it's not a drug but a procedure perhaps? Or that there is NO quantified benefit/risk profile established at all (maybe for the reasons that Dr. Brandes writes that even angioplasty doesn't have proper trial data behind it)? Or maybe the death from blood-thinners and the migrating stent incident scared hospital administrators into thinking that perhaps informed consent could NOT be given without better knowing the risks involved through implementing investigation protocols first before allowing widespread treatment?
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