SaintLouis wrote:Dr. Cumming,
In trying to think of ways to reduce the possibility of a blood clot post-surgery, do you think if one has the choice to have the procedure in the winter or the summer the summer would be better since blood is "thinner"? Maybe a long shot but I'll do anything I can to increase my odds of a better outcome.
Cece wrote:Terminology can be a bear: by venogram, do you mean the MRV or the catheter venogram?
Can you tell us at all what you have experienced with the MRVs as part of the diagnostic process? Do they hold up to what you see in the catheter venogram? Have you had anyone back for a repeat MRV after a successful venoplasty? I've also been wondering for awhile: if there is a figure for "backward flow" in the flow chart information for the jugulars, does this mean backward toward the brain or backward toward the heart?
DrCumming wrote:Brainteaser wrote:Cece, I'd like to hear what Dr Cumming has to say on this very serious issue. As you quote '....repeated dilatation causes repeated intimal injury and perpetuates the intimal healing response. ' If people are being retreated frequently, there is greater potential for intimal damage. Additionally, my reading of 'Re-stenosis occurring 3 to 12 months after angioplasty is typically due to intimal hyperplasia.' does not necessarily mean that there can't be intimal damage in less than 3 months.
We know, from our dialysis patient population, that we can safely redilate veins many many times. I have a group of patients that routinely come in every 3 - 6 months for repeat dilation.
We always cause intimal injury by ballooning. To gain luminal diameter, it has too happen.
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