The problem is that the best, safest practices have not been established yet. You seem to place high importance on pre-anti-coagulation, yet many doctors with greater experience are using anti-platelet or nothing. I don't think San Diego gives ANY thinners for a straight angio. Yet you don't seem concerned with increased thrombosis risk from larger balloons even though many doctors stick to sizes that mirror vein size.
I've heard a doctor say that he's seen the damaging results to veins from the prior use of cutting balloons, yet you have not brought this up as a particular concerning issue.
So we really need more results to know what determines what "best practice" ends up being. It hasn't been revealed yet and without evidence, sometimes all we can do is wait, or if we don't want to do that, then trust the expertise and judgment of the doctor we choose. We aren't doctors after all. Many well qualified doctors with a lot of experience are doing things differently. No one can say they're doing it "wrong", not without data that shows overall results. I don't see experienced doctors changing their anti-coagulation or stenting practices; unless we don't trust their expertise or judgment, I just think they are in a better position than us to determine the most effective and safest way to treat, in the absece of hard data to the contrary. These doctors have great reputations and are well qualified for the most part. And there are no guarantees as we well know by radeck's stent migration in the hands of an extremely capable physician with an impeccable reputation. Things happen and not all risks can be eliminated.
You may feel protected with a pre- anti-coagulation regime, but how do you know that you're not increasing your risks anyway with the possible use of oversized or cutting balloons?
I just think that doctors are better at weighing these risks. Trust in the doctor seems most important rather than trying to guess "best treatment" of something that is beyond our pay-grade/knowledge. If the experienced doctors don't agree on the best approach, I don't think we should put the burden on ourselves and expect US to know what's best with even less knowledge and no experience, not without hard evidence which we can always wait for.
Yes, research your doctor and don't choose one arbitrarily, find one that you trust and has a good reputation. But I don't think we can expect to be able to determine best treatment methods when very capable doctors haven't been able to agree. Learn your risks and find a doctor that conforms to the level you are prepared to undertake in ALL areas, understanding that data is lacking and that no one can know for sure what the best way to treat CCSVI is.