Cece wrote:I don't fully get it either. It used to be okay to experiment with new surgical techniques but now this needs to be done under IRB so that hospitals and docs don't get sued (and patients are protected)? Or it is ok to experiment with surgical techniques on an individual but not a cohort (such as the cohort of MSers).
One of the things I took away from DrS's Italy speech was him repeating that these findings in veins are abnormal.
Abnormal needs fixing. Docs remove ruptured appendixes because they are abnormal; they'll fix abnormal veins too, soon as they all agree with dear DrS that these are indeed abnormal.
I don't think "abnormal" is the standard. I think it is "harmful and can be fixed". In other words, it may be abnormal to have one eye green and one eye brown, but that is not harmful, whereas if you have cataracs, that may be normal for someone your age, but it is harmful and can be fixed.
The problem is that stenosed veins have not been scientifically proven to be harmful, according to the neuros. It certainly has not been proven to be the cause of MS yet, with this I agree. However I think poor blood flow to the brain or spinal cord strikes me as per se harmful, and I think that the work already done by Zamboni and Sclafini show that with mere angioplasty, it can be fixed.
I am not sure surgeons would like to say that what they are doing using a known technique (angioplasty) for a new use (clearing vein stenosis) is experimenting, but I guess to some extent it is. IRs do that all the time, though. They use it to clear up blockages all over, if it does not seem to dangerous. My late step father had angioplasty in his carotid arteries, and also in his esophegus when he was having troulble swallowing. They use it all over the body.
If it were a totally new tecnique, that definitely would be experimenting.
And I think you are absolutely right, I think the main reason that hospitals insist that the doctors do the work under IRB approval is to protect against lawsuits. I am almost ashamed to admit it, but I am a lawyer, and I understandhow Dr. Dake using stents to treat MS would scare the crap out of Stanford, especially after one or two adverse events.
(Also as a lawyer, I am especially amazed and in awe of Dr. Sclafini and all his willing advice given over the internet!!! I note that no other doctors are willing.)