This Is MS Multiple Sclerosis Community: Knowledge & Support

Welcome to the world's leading forum on Multiple Sclerosis research, support, and knowledge. For over 10 years, This is MS has provided an unbiased community dedicated to Multiple Sclerosis patients, caregivers, and affected loved ones.
It is currently Fri May 24, 2013 3:35 pm


All times are UTC - 8 hours [ DST ]




Post new topic Reply to topic  [ 78 posts ]  Go to page Previous  1, 2, 3, 4, 5, 6
Author Message
 Post subject:
PostPosted: Wed Jul 07, 2010 1:58 pm 
Offline
Family Elder

Joined: Mon Jan 04, 2010 4:00 pm
Posts: 8511
Thanks, Nunzio, great link too...I see exactly what you're saying about the backbone.

You say a stent would still be good in the above case, do you disagree with the reasons DrS gave for why he would not stent there?
Quote:
1. stenting a physiological narrowing may be a problem when that narrowing distends by treatment of lower more likely stenoses. it is possible that the stent will no longer be pressed against the wall of the vein and thus migrate toward the heart.
2. stents have the risks of in-stent stenosis leading to loss of the vein completely...certainly do not want to put one there for a physiological distensible narrowing
3. putting pressure on the wall of the carotid at the carotid bulb by stenting the vein may result in physiological responses including a slow heart rate

_________________
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition


Top
 Profile  
 
 Post subject:
PostPosted: Wed Jul 07, 2010 3:36 pm 
Offline
Family Elder
User avatar

Joined: Thu Jan 14, 2010 4:00 pm
Posts: 254
Location: South Florida
Cece wrote:
Thanks, Nunzio, great link too...I see exactly what you're saying about the backbone.

You say a stent would still be good in the above case, do you disagree with the reasons DrS gave for why he would not stent there?
Quote:
1. stenting a physiological narrowing may be a problem when that narrowing distends by treatment of lower more likely stenoses. it is possible that the stent will no longer be pressed against the wall of the vein and thus migrate toward the heart.
2. stents have the risks of in-stent stenosis leading to loss of the vein completely...certainly do not want to put one there for a physiological distensible narrowing
3. putting pressure on the wall of the carotid at the carotid bulb by stenting the vein may result in physiological responses including a slow heart rate

Partially: the way I would proceed is this, related to # 1.
I would balloon the lower stenosis.
Recheck upper narrowing; if gone do nothing.
If still present since narrowing=decreased flow I would ask the patient to go in valsalva and measure the diameter of the vein and then use a slightly larger stent. Alternatively a compliant balloon (soft,low pressure) could be used just to assess the vein diameter. This should prevent stent migration.
Point #2 and #3 I would defer to Dr.Ludyga and Simka.
They have done hundreds of these procedures without apparently any major problem.
Cece, maybe we can open a liberation treatment center together; I am not an I.R. or Vascular surgeon, but I have an Italian name.

_________________
Everybody here brings happiness, somebody by coming,others by leaving.  PPMS since 2000<br />


Top
 Profile  
 
 Post subject:
PostPosted: Wed Jul 07, 2010 3:41 pm 
Offline
Family Elder

Joined: Mon Jan 04, 2010 4:00 pm
Posts: 8511
Nunzio wrote:
Cece, maybe we can open a liberation treatment center together; I am not an I.R. or Vascular surgeon, but I have an Italian name.

I'm in. I have a baggie full of balloons and pretty sure I can pick up any stents or that sort of thing at the hardware store. :)

We just need some guy named Irb to watch over us and we're set.

_________________
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 78 posts ]  Go to page Previous  1, 2, 3, 4, 5, 6

All times are UTC - 8 hours [ DST ]


Related topics
 Topics   Author   Replies   Views   Last post 
There are no new unread posts for this topic. Dr. Sclafani interview from Italy...

cheerleader

8

1713

Fri Jun 11, 2010 6:29 pm

bestadmom View the latest post

There are no new unread posts for this topic. Treatment in Italy - When?

fernando

6

1516

Sun Sep 20, 2009 8:19 am

spiff View the latest post

There are no new unread posts for this topic. Surgeries in Italy??????

lovebug

4

1872

Wed Jul 14, 2010 4:04 am

joge View the latest post

There are no new unread posts for this topic. Liberation Day, Italy

Cece

2

738

Thu Apr 21, 2011 6:22 am

Cece View the latest post

There are no new unread posts for this topic. There's something going on in Italy: Zamboni blocked

[ Go to pageGo to page: 1, 2 ]

Inge67

22

3421

Mon Nov 30, 2009 11:58 am

mrhodes40 View the latest post

 


Who is online

Users browsing this forum: No registered users


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum

Search for:
Jump to: