KUWAIT - Has anyone heard

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KUWAIT - Has anyone heard

Postby Gordon » Mon Oct 18, 2010 12:55 pm

So has anyone heard what has happened in Kuwait
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Postby Cece » Mon Oct 18, 2010 1:36 pm

It has been said (but nothing published) that Dr. Sinan of Kuwait has done over 200 procedures. He uses aggressive ballooning since he is not allowed to use stents. He is said to be finding restenosis rates of 2% (meaning that 98% of his patients did not restenose) at three months post-procedure. If accurate, those are unprecedented results for CCSVI. He also has an innovative technique where he balloons the azygous lightly as a diagnostic tool and then balloons big if he finds anything. He spoke at the Brooklyn CCSVI symposium hosted by Dr. Sclafani in July, these vids can be watched on youtube.
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Postby Donnchadh » Mon Oct 18, 2010 2:29 pm

Cece wrote:It has been said (but nothing published) that Dr. Sinan of Kuwait has done over 200 procedures. He uses aggressive ballooning since he is not allowed to use stents. He is said to be finding restenosis rates of 2% (meaning that 98% of his patients did not restenose) at three months post-procedure. If accurate, those are unprecedented results for CCSVI. He also has an innovative technique where he balloons the azygous lightly as a diagnostic tool and then balloons big if he finds anything. He spoke at the Brooklyn CCSVI symposium hosted by Dr. Sclafani in July, these vids can be watched on youtube.


Does anyone have a link to the Dr. Sinan youtube video? I am very curious about his techniques.

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Postby frodo » Mon Oct 18, 2010 3:25 pm

Donnchadh wrote:
Cece wrote:It has been said (but nothing published) that Dr. Sinan of Kuwait has done over 200 procedures. He uses aggressive ballooning since he is not allowed to use stents. He is said to be finding restenosis rates of 2% (meaning that 98% of his patients did not restenose) at three months post-procedure. If accurate, those are unprecedented results for CCSVI. He also has an innovative technique where he balloons the azygous lightly as a diagnostic tool and then balloons big if he finds anything. He spoke at the Brooklyn CCSVI symposium hosted by Dr. Sclafani in July, these vids can be watched on youtube.


Does anyone have a link to the Dr. Sinan youtube video? I am very curious about his techniques.

Donnchadh


The link
http://www.youtube.com/watch?v=cChReoCFEN0
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Postby GuRu » Mon Oct 18, 2010 3:26 pm

Donnchadh wrote:
Cece wrote:It has been said (but nothing published) that Dr. Sinan of Kuwait has done over 200 procedures. He uses aggressive ballooning since he is not allowed to use stents. He is said to be finding restenosis rates of 2% (meaning that 98% of his patients did not restenose) at three months post-procedure. If accurate, those are unprecedented results for CCSVI. He also has an innovative technique where he balloons the azygous lightly as a diagnostic tool and then balloons big if he finds anything. He spoke at the Brooklyn CCSVI symposium hosted by Dr. Sclafani in July, these vids can be watched on youtube.


Does anyone have a link to the Dr. Sinan youtube video? I am very curious about his techniques.

Donnchadh



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http://www.youtube.com/watch?v=cChReoCFEN0
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Postby David1949 » Mon Oct 18, 2010 5:32 pm

Thanks for the heads-up on Dr. Sinan's presentation. That was outstanding, one of the best I've seen. He answered several questions I've had about the angioplasty process. And his treatment of the azygous vein is unique, I think. He reports finding webs or abnormal valves in the azygous of 95% of his patients, by using his technique. That is much higher than what is reported by patients who post on Thisisms. Add that to the very low restenosis rate he reports and it seems his work is deserving of study by others. I'm anxious to see the results of the trials they are currently doing.
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Postby David1949 » Mon Oct 18, 2010 5:43 pm

Several people have reported that they thought the azygous was their problem. But during venograprhy their jugulars were stenosed but their azygous was clear. I wonder how many of those people in fact have the problems Dr. Sinan is finding in the azygous.
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Postby Cece » Mon Oct 18, 2010 5:59 pm

David, I'm with you, I think what Dr. Sinan is finding is real, so the difference between his 95% azygous stenosis findings and the percentage of what the other docs are finding there (Simka's results were recently posted, it was a really low figure) would be the missed azygous stenosis group, IMO.
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Postby Drury » Mon Oct 18, 2010 7:57 pm

David and Cece,I am with you both too. Just wish all doctors could be on the same page.

There was a case I saw a month or so ago on this site of another person being treated by Dr. Sinan in Egypt rather than Kuwait, who did not have good results. I cannot find it (sorry I'm useless with computers) but think they were quite a bit worse off than before they went.

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Postby drsclafani » Mon Oct 18, 2010 8:49 pm

Drury wrote:David and Cece,I am with you both too. Just wish all doctors could be on the same page.

There was a case I saw a month or so ago on this site of another person being treated by Dr. Sinan in Egypt rather than Kuwait, who did not have good results. I cannot find it (sorry I'm useless with computers) but think they were quite a bit worse off than before they went.

Drury


Data from medical tourism is going to compromised by difficulty in obtaining accurate followup.

I need to see a publication
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Postby daniel » Thu Oct 21, 2010 10:52 am

Is it still possible to get an appointment in kuwait? Anyone know where to go about doing that...?
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Postby scorpion » Thu Oct 21, 2010 10:55 am

Cece wrote:David, I'm with you, I think what Dr. Sinan is finding is real, so the difference between his 95% azygous stenosis findings and the percentage of what the other docs are finding there (Simka's results were recently posted, it was a really low figure) would be the missed azygous stenosis group, IMO.


What makes you believe his findings are real? I am just curious.
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Postby 1eye » Thu Oct 21, 2010 11:49 am

drsclafani wrote:Data from medical tourism is going to compromised by difficulty in obtaining accurate followup.

I need to see a publication


I don't call it medical tourism for Liberation treatments not available locally. I got no tours as freebies with my trip to Albany. Those physicians who choose to run a clinical trial, and do arrange local follow-up for and with their patients, are not compromised in any way. They have just enlisted local physicians to take part in their trial.

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Last edited by 1eye on Thu Oct 21, 2010 11:53 am, edited 1 time in total.
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Postby Cece » Thu Oct 21, 2010 11:50 am

Scorpion, it's because what I understand of his diagnostic technique in the azygous (partially inflating a balloon throughout the entire azygous and looking for where a web or something is providing resistance), it's really smart.

IVUS and properly imaging the azygous were among the solutions, then Dr. Sinan added his solution, all addressing an already identified problem.
(edited: apparently these are a different sort of azygous web, not the garbage pail lid kind.)

But I agree that we need published research to know for sure.

Daniel, it's never been possible to be treated in Kuwait unless you are Kuwaiti, but Dr. Sinan has been bookable for treatments in Egypt. There was a blog of a patient's experience there, where Dr. Sinan kept trying to get a resistant stenosis to open and was considering giving up but he went to the highest balloon diameter he uses and swooosh it opened. Not sure of the ultimate outcome.
1eye wrote:I don't call it medical tourism for Liberation treatments not available locally.

Hi, 1eye!

I think that is the very definition of medical tourism: traveling for a procedure either not available locally or not available at the price you want. The problem is that there are three parts to the venoplasty treatment and each part is as important as the next: first finding all the CCSVI issues through imaging and during the procedure; then successfully opening them all; then keeping them open through anticoagulants and post-procedure doppler scans at 1 month, 3 months, etc, to catch any problems. Dr. Sinan has done a great job with some innovative techniques at first finding, then opening, the ccsvi malformations, but then the patients go home and that third part of the follow-up care is done differently by everyone and poorly by some.
Last edited by Cece on Tue Oct 26, 2010 8:06 pm, edited 1 time in total.
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Postby 1eye » Thu Oct 21, 2010 12:04 pm

scorpion wrote:
Cece wrote:David, I'm with you, I think what Dr. Sinan is finding is real, so the difference between his 95% azygous stenosis findings and the percentage of what the other docs are finding there (Simka's results were recently posted, it was a really low figure) would be o the missed azygous stenosis group, IMO.


What makes you believe his findings are real? I am just curious.


I agree with Cece. The methods, both of Dr. Sinan and with IVUS, are likely to find stenoses and CVMs, where a fluoroscope would miss them. As the paper I quoted yesterday said, IVUS is also likely to be very helpful in preventing damage to real valves.
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