Stenting & Restenosis

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

Stenting & Restenosis

Postby nn98200 » Tue Jun 01, 2010 7:00 pm

Hello everyone,

I had balloon angioplasty in Poland in the middle of March after which I had a great improvement for about two weeks. Afterward most of my improvement went away and I became even worse than before the procedure. Last Thursday I had venography locally (Albany) that found out one more narrowing of about 50-60% at the top of my left jugular vein in addition to the two narrowings the docs found in Poland (one of the bottom of the left and one of the right jugular). Is it possible that the third narrowing appeared as a result of the angioplasty in Poland? I doubt it that they'd miss something like that in Poland and I am afraid it is a result of the angioplasty. But my much bigger concern is that after the 2nd angioplasty here I only had one day, which was the day right after the procedure, that I felt a big improvement of symptoms. Since then I have been feeling just like before the procedure. Of course, I started to think I have restenosis again and I need stenting. But today I talked to the doctor and he expressed the opinion that stenting may be too risky in my case because my veins seem to restenose very fast and the stent(s) may not be able to hold them. He said that if the stent collapses they have no options at all how to help me. I know that there are many people who had stents in Poland and in Stanford (with even bigger stenosis than mine which is about 50% at the three narrowings and Dr Dake didn't do just ballooning at first to check if and how quickly these veins would restenose and decide if a stent is a good option). I would really appreciate any opinion. Please share your experience with stenting! Has anyone had a similar problem? I forgot to mention that the doctor said he had a patient whose stent collapsed. Thank you so much in advance!
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Postby Cece » Tue Jun 01, 2010 10:15 pm

Wow...can you ask about this in Dr. Sclafani's thread? It's a real surprise to hear this concern about the stents collapsing...I think they're pretty solid...but it sounds like this doc in Albany speaks from experience.
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Postby nn98200 » Wed Jun 02, 2010 8:26 am

Hi Cece,

Thanks for the great advice! I also thought stents are pretty solid and chances of collapsing are very slim.

By the way, this morning I was stunned by the lightness and the looseness of my legs that I had right after getting up! I walked 100 meters on my own (with little stops) even before taking a shower to loosen my body (a few months ago I could do that but only after taking a shower and far not as well as now)! I felt like I felt a day after the procedure in Poland! Even better than the improvement I had last Friday - the day right after the procedure here! I really thought I had restenosed as I was not doing well since Friday last week! But the issue with stenting remains. I am also worried about the third narrowing the doctor found after the angio here - can a new narrowing pop up after an angio??? (Regarding the doctor who did my angio - I didn't put the name as it was advised on the forum not to do that but he was discussed here. You can pm if you wish) Thanks!
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Postby sofia » Wed Jun 02, 2010 9:13 am

I can not really add anything here. I do not have any information.
But....I had liberation done may 12th, and continued improoving up untill this weekend. It was great. But today I'm feeling really lousy. Not all symptoms are back but my eye and the vertigo is giving me bother again. Today vertigo is really bad :-(
I'm fearing that jugulars have restenosed, both or just the one. Emailed Bulgaria today but not heard back yet. I was thinking it was quick to restenose, but maybe the risk is decreasing with time.
Very educational your posting here, so thanks for sharing.
<div>I have lived with ms for 8 years. The last year has been hell, I've gone from shite to even worse every single month, until my liberation in May. </div>
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Postby Cece » Wed Jun 02, 2010 9:29 am

nn98200 wrote:I am also worried about the third narrowing the doctor found after the angio here - can a new narrowing pop up after an angio???

Yes, I am pretty sure this has happened. Wasn't Dake often adding new stents on the follow-up two month visit?

I can't say I fully understand the topic of narrowings, but here is what I think I know: a narrowing in one part of the vein may not need treatment where it's at, it may be indication of a malformation somewhere lower down. It's all blood flow. Narrowings, if they expand under IVUS, may not be stenosis or malformations but might be the result of lower blood inflow...less blood is flowing in because less blood is flowing out, so there is a blockage somewhere, but if the narrowing expands under IVUS, the blockage is not there. (And if it's a new narrowing, I would think it's pretty certain that it would expand under IVUS and that it's not a fixed solid stenosis, because if it was it would've been there the first time.) The idea is that there is a problem lower down, the blood flows a short bit up from there and out the collaterals, and higher up is the narrowing because there is less blood flowing in, because of the lower-down problem.

If it were me and I still had a higher-up narrowing, I'd keep trying to find a doctor willing to look for a valve or membrane or something lower down...and hopefully skilled enough to find it.

Glad to hear you are feeling better again and hope it stays this time!!
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