Impression: Bilateral internal jugular vein reflux with incompetent valves. Left valve leaflet which is immobile. Right valve leaflets did not oppose one another.
drsclafani wrote:Could ballooning solve valve problems?
The valves are leaflets of tissue that are attached to the wall and close periodically by coming together. in ccsvi Some of the valves are thickened mounds of tissue that do not open and close at all, some just do not open all the way, some do not close all the way, some seem to have the leaflets fused partially or completely. , some form pockets adjacent to the lumen and balloon up some times. In all situations they restrict the flow of blood coming out of the neck and brain.
Angioplasty attempts to tear the valve's attachment to the wall or split apart any fusion of the leaflets, or stretch wall adjacent to it. So it is not one question, one problem, or one solution. I do see improved flow, but we will have to wait to understand the natural history of the treatments.
We have a long way to go to understand these problems and determine the best way of treating the various problems. Bottom line, stay tuned. and keep asking the good questions.
Does that help you?
drsclafani wrote:The valves can have many different abnormalities.
1. they can have their leaflets fused, thickened, stiff
2. They can be misplaced, misoriented, misdirected
3. They can be incomplete and result in septae, duplications, webs
perhaps you can sense, that i think there is no one size fits all solution, nor do i think that all these abnormalities will have a single feature, outcome, result of treatment
Some surely will require some form of device to hold them open, such as a stent. Some will require surgery
in truth, we just do not know yet. We have not even had one research paper focused on the valve issues. We do not have proper equipment
My experiences with IVUS showed me that many of the narrowings are really valvular problems. These particular problems seemed to dilate well after cutting balloons. The fused valve leaflets just tear open. other valve problems just do not go away with angioplasty.
sorry about the answer, but we will solve these questions
newlywed4ever wrote:This bears repeating - CONGRATS!! My thought is for you to wait for our hero
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