WinnipegGirl_83 wrote:Thanks Cece, Irina and CentreofGravity,
Is it not possible for any IR to perform this procedure? Do you have to be an expert? Obviously, the more knowledge the better, but isn't the procedure fairly uniform across the globe?
Being from Canada this is an out of pocket expense as well, $15 000 the first time, fairly similiar the second time...I hope my second procedure holds. With that being said, I have my fingers crossed I can even be treated this time around.
That is so expensive.
Yes, any IR can perform the procedure. I have been paying attention to the various docs methods, they're all doing things differently. (omg) (Lyon, you still around? You've been sparse as of late.) There's not much science or research to recommend one method or another, so it's all clinical knowledge and it can be a tough call.
Let's see. You originally went to Dr. Sinan. You may have had large balloons but at normal pressures and nearly the highest degree of blood thinners that any of the docs are doing (Clexane, plavix and aspirin - would love for this to be reconfirmed?). With all those thinners, it's not certain but there would seem to be less chance of clotting as the cause of restenosis. You were treated by a doctor with many many procedures under his belt. But it may have been a short procedure, I have heard from a patient that he does 5 - 6 per day when he's in Egypt (anyone can confirm?).
So if you look for a doctor who does the things Dr. Sinan didn't, you'd be looking for a doctor who uses the high pressure balloons and spends a lengthier amount of time on each patient so perhaps anything missed in the first procedure would be found in the second. If we assume restenosis is due to elastic recoil, it also seems that doing the same thing again would result in the same results, although that too isn't known.
Some concerns would be if you can't risk having to pay for a third procedure (then go for the more aggressive methods) or if you are worried about any risks from the high pressure balloons (then go for less aggressive). Dr. Sinan's methods were already on the aggressive side and failed to have 'durable' results.
IMO things to avoid would be doctors who use stents and doctors who do not prescribe true anticoagulants. My opinion is that both of those increase the risk too high.
I wish the decision were easier. Not sure if I have been any help!