Interesting he can correlate the clinical discourse of CCSVI with the disease of MS - slide 60 ... and that's basically what we've all seen.
Was that the one that said supratentorial lesions were associated with bilateral jugular lesions? I had to look up supratentorial.
Unilateral jugular lesions were associated with optic neuritis; severe azygous stenosis with severe disability. He had also treated a patient with ADEM with stenosis in all three veins.
The twisting of the azygous he seems to think is worth stenting (slide 53) - which I wonder if that is the opening/closing (phasic) of the azygous.
That phasic opening/closing is something new entirely, I believe. I posted some research awhile back about twisting in veins, it was interesting, a vein can twist quite far and be fine and then a little further is when it closes off, it's dramatic...but we don't yet know if there really are twisted azygouses, we've heard about them but haven't seen the images or IVUS images.
All of these presentations make sense ... I just wish we were 5 years in the future and had all of this figured out for EVERYONE
It's tough, with CCSVI being so different from one patient to the next. It would seem that fused leaflets at the base of the jugulars is one of the easier presentations; then azygous valves; then annular stenoses; then some of the azygous webs and membranes that are balloonable if you can find them; and the hardest are things like hypoplastic veins or jugular vein partial duplications or that phasic opening/closing azygous. By their rarity, too, it'll take longer for doctors to see enough cases to have an answer, and there aren't easy answers, and from one doctor to the next they disagree even about some of the easier presentations...we have years ahead of us.
I looked at my IVUS images yesterday, with the white badly flapping valve leaflets, and it strikes me how something so small had such a global effect on my health and life.