Medscape Summary of CCSVI at ECTRIMS

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

Postby PCakes » Thu Nov 18, 2010 6:51 pm

marcstck wrote:
PCakes wrote:Dr Zivadinov said...
"I think based on this study that we can't say more than there is no deterioration of the patients who are getting this type of treatment...


please ..what the heck does this mean? I've read it every which way to Sunday and must be putting the emPHAsis on the wrong sylLABle??

Marc, thank you for your insight..:)


I believe this means that the treatment isn't harming any of the patients who get it. In other words, angioplasty (or, more correctly venoplasty) itself is a safe procedure…


mr success wrote:
I believe this means that the treatment isn't harming any of the patients who get it. In other words, angioplasty (or, more correctly venoplasty) itself is a safe procedure…


I would suggest Dr. Zivadov is indicating ..... that the treatment seems to halt progression. If I understand it correctly .

This in itself ..... is huge .


Thanks Mr. S. & Marc.. two possibilities, both pieces in my puzzle, and both good.. :)
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Postby cheerleader » Thu Nov 18, 2010 7:47 pm

PCakes--if you need a tie breaker, I have to side with Marc. Dr. Zivadinov is merely stating that at this point, angioplasty appears to be well-tolerated, but it is not clear what the future benefits will be. Relapses were down and lesions were down in the treated group--but it will take a while longer to know if progression is indeed halted.

That said, Dr. Dake has reported that in the 20 patients he has seen for a new MRI at a year since angioplasty, NONE had new lesions.
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby PCakes » Thu Nov 18, 2010 8:06 pm

cheerleader wrote:PCakes--if you need a tie breaker, I have to side with Marc. Dr. Zivadinov is merely stating that at this point, angioplasty appears to be well-tolerated, but it is not clear what the future benefits will be. Relapses were down and lesions were down in the treated group--but it will take a while longer to know if progression is indeed halted.

That said, Dr. Dake has reported that in the 20 patients he has seen for a new MRI at a year since angioplasty, NONE had new lesions.
cheer


Thank you !! :)
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Postby CCSVIhusband » Thu Nov 18, 2010 8:10 pm

^ but wouldn't that signify what we were saying ... that none had gotten worse. Not that they had gotten better, but no new lesions is "not getting worse".

:D

Either way, it's good ...
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Postby Billmeik » Thu Nov 18, 2010 8:32 pm

No significant clinical or MRI differences have been seen, although there were less relapses in the immediate treatment group, 1 vs 4, and a decrease in T2 lesion volume in the immediate group, about 10%," Dr. Zivadinov noted. Restenosis did not occur in any of the azygous veins treated but was seen in 29% in the internal jugular veins.



so 1 relapse for the liberated group and 4 for the others.

no talk of a stop in progression but a 10% reduction in T2 lesion volume is a lot isn't it?
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Postby MrSuccess » Thu Nov 18, 2010 11:39 pm

no clinical or MRI differences .? ..... is that not a halt to progression ?

Not calling you out - ringleader - ...... it just reads that way to me.


I still have not read the ECTRIMS reports ...... other than Dr. Simka's.

Surprised it hasn't been in the spotlight .




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Postby malden » Fri Nov 19, 2010 6:04 am

Billmeik wrote:...
A Matter of Assessment?

The appealing idea that simple angioplasty of extracranial veins might cure or improve symptoms of this devastating disease caught the attention of highly educated and motivated MS patients late last year and has since engaged many in the unifying demand for access to what has been dubbed by some the "liberation procedure."

Dr. Zamboni — who denies having called it the liberation procedure — and colleagues presented new data here and addressed some of his critics. At the packed Charcot Symposium dedicated to discussion of the topic at the outset of the meeting, he first emphasized what these venous lesions are and what they are not.

"CCSVI is composed of several blockages in the main outflow routes, the jugular vein, azygous vein, but this is very important to understand," he said, displaying angiographic and high-resolution B-mode images along with a specimen, these blockages "are merely intraluminal defects; not problems in the wall, but intraluminal defects: webs, membranes, malformed valves."
...


Why then most common Liberation procedure is just simple angioplasty solving vein wall problems if CCSVI blockages are "not problems in the wall", but " intraluminal defects: webs, membranes, malformed valves"?

Does it mean that angioplasty is unnecessary procedure for solving CCSVI, because it does not solve intraluminal defects: webs, membranes, malformed valves?
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Postby CCSVIhusband » Fri Nov 19, 2010 6:24 am

Malden wrote:
Billmeik wrote:...
A Matter of Assessment?

The appealing idea that simple angioplasty of extracranial veins might cure or improve symptoms of this devastating disease caught the attention of highly educated and motivated MS patients late last year and has since engaged many in the unifying demand for access to what has been dubbed by some the "liberation procedure."

Dr. Zamboni — who denies having called it the liberation procedure — and colleagues presented new data here and addressed some of his critics. At the packed Charcot Symposium dedicated to discussion of the topic at the outset of the meeting, he first emphasized what these venous lesions are and what they are not.

"CCSVI is composed of several blockages in the main outflow routes, the jugular vein, azygous vein, but this is very important to understand," he said, displaying angiographic and high-resolution B-mode images along with a specimen, these blockages "are merely intraluminal defects; not problems in the wall, but intraluminal defects: webs, membranes, malformed valves."
...


Why then most common Liberation procedure is just simple angioplasty solving vein wall problems if CCSVI blockages are "not problems in the wall", but " intraluminal defects: webs, membranes, malformed valves"?

Does it mean that angioplasty is unnecessary procedure for solving CCSVI, because it does not solve intraluminal defects: webs, membranes, malformed valves?


Dear Colin:

Angioplasty does address webs, membranes, and malformed valves. Maybe not as permanently as we'd like, but it addresses them nonetheless. (maybe stents are needed more than we'd like to admit in a lot of cases though, and they'd be a better solution).

The thought is to push a web up against the vein wall, and hopefully incorporate it into the wall, or to break it up enough that it doesn't restrict flow.

Valves are ballooned either into the wall, or back to a normal position, remember that 15% of all persons do not have valves in their jugular veins. So, not nearly 15% of the population have valves. (Hence, maybe we don't even need valves - if that's the case ... a stent holding them open might not be a bad thing - if properly cared for and determined that is the best method).

Methinks you're just looking to pick a "fight" ...

Have a good weekend.
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