valvulotomy vs ballooning?

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valvulotomy vs ballooning?

Postby Cece » Fri Mar 11, 2011 4:19 pm

Dr. Zamboni has applied for a patent on a valvulotomy device:

A DEVICE FOR TREATING VALVULAR MALFORMATIONS IN PERIPHERAL VENOUS VESSELS, SUCH AS INTERNAL JUGULAR VEINS AND KIT THEREFOR

Abstract: A device for venous valvulotomy, usable for example for valvulotomy of the jugular veins includes: - a cutting tool (12) having at least one cutting formation (120) for performing the action of valvulotomy; and - a collection element (14), set in a proximal position with respect to the cutting tool (12) for collecting the residue of valvulotomy entrained by the blood flow from the cutting tool (12).

http://www.wipo.int/pctdb/en/wo.jsp?IA=IB2010053355

Is he having success with valvulotomy as compared to ballooning? My thought is that valvulotomy has a greater risk of clotting, particularly in the low-flow, posture-dependent jugulars.
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Postby Nunzio » Sat Mar 12, 2011 4:31 am

This is the picture of the device.
I do not think the risk of clotting is significant.
Image
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Postby sara-sama » Sat Mar 12, 2011 9:56 am

Dr. Sinan told us that he uses this way,

my sister had (Als) .. she tried to travel for re-catheter and Make (valvulotomy) vs ballooning, but unfortunately .. she could not travel because of the deterioration of her health .
she died two weeks ago ..
Last edited by sara-sama on Sat Mar 12, 2011 5:10 pm, edited 1 time in total.
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Postby Cece » Sat Mar 12, 2011 10:15 am

Sara-sama, condolences for your loss. I am sorry to hear of it.

Nunzio, thank you for the diagram, where did you find it? It's helpful.

If cutting balloons increase the risk of clotting, which I have heard here to be true, then a valvulotome would also increase the risk of clotting, as it is a bigger intervention than a cutting balloon?
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Postby PCakes » Sat Mar 12, 2011 10:37 am

Nunzio wrote:This is the picture of the device.
I do not think the risk of clotting is significant.
Image


wow! this thing is amazing... I wonder if something similar is being considered for clearing blockages. I'm picturing gentle tunneling tools and if that 'catch it' basket works it would certainly decrease the risk of clots escaping.
Science is awesome.
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Postby Nunzio » Sat Mar 12, 2011 4:07 pm

The basket should work.
IR are used to Inf Vena cava filters that look like umbrellas and are used to catch blood clot from the legs and prevent pulmonary embolism.
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Postby Nunzio » Sat Mar 12, 2011 4:13 pm

Cece wrote:Sara-sama, condolences for your loss. I am sorry to hear of it.

Nunzio, thank you for the diagram, where did you find it? It's helpful.

If cutting balloons increase the risk of clotting, which I have heard here to be true, then a valvulotome would also increase the risk of clotting, as it is a bigger intervention than a cutting balloon?

My guess is that the cleaner the cut the less chance of clotting.
Cutting balloons create more of an indentation and tear than a cut and that might be the reason for the higher risk of clotting.
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Special Tool

Postby MarkW » Sat Mar 12, 2011 4:32 pm

The title of this thread is misleading. It is not Valvulotomy verses Ballooning but Valvulotomy or Ballooning. Solving valve issues by valvulotomy may be a future development. I am not familiar with the approval processes for new surgical equipment. If it is like approval of an internal medical device it could take years before this device could be available for use on our faulty valves.

Markw
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Postby Trish317 » Sat Mar 12, 2011 5:09 pm

sara-sama wrote:Dr. Sinan told us that he uses this way,
he said that all patients who have been subjected to this procedure did not have restenosis ..

my sister had (Als) .. she tried to travel for re-catheter and Make (valvulotomy) vs ballooning, but unfortunately .. she could not travel because of the deterioration of her health .
she died two weeks ago ..


I'm so sorry for your loss. My thoughts and prayers are with you and your family.
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Postby sara-sama » Sun Mar 13, 2011 7:56 am

Cece wrote:Sara-sama, condolences for your loss. I am sorry to hear of it.




Trish317 wrote:
I'm so sorry for your loss. My thoughts and prayers are with you and your family.



Thanks Cece & Trish
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Postby Liberation » Mon Mar 14, 2011 6:44 am

sara-sama wrote:Dr. Sinan told us that he uses this way,

my sister had (Als) .. she tried to travel for re-catheter and Make (valvulotomy) vs ballooning, but unfortunately .. she could not travel because of the deterioration of her health .
she died two weeks ago ..


Condolences for your loss.
Do you know anything about dr Sinan's technique? Does he use the valvulotomy or the cutting ballon?
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Postby sara-sama » Mon Mar 14, 2011 11:49 am

Liberation wrote:
Condolences for your loss.
Do you know anything about dr Sinan's technique? Does he use the valvulotomy or the cutting ballon?


Thanks Liberation
I do not know waht his technique exactly ..
I understood that he cut the valve to keep the vein open ..
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Re: Special Tool

Postby Cece » Mon Mar 14, 2011 12:17 pm

MarkW wrote:The title of this thread is misleading. It is not Valvulotomy verses Ballooning but Valvulotomy or Ballooning. Solving valve issues by valvulotomy may be a future development. I am not familiar with the approval processes for new surgical equipment. If it is like approval of an internal medical device it could take years before this device could be available for use on our faulty valves.

Markw

I am pondering the differences between vs and 'or' now! Versus is if it is a head-to-head challenge, 'or' is if it is merely one or the other?

For myself I prefer Ballooning to valvulotomy, at least until there is more information on how the blood vessel tolerates valvulotomy, as the latter does seem more invasive. But I have seen some images -- I am thinking of one that Dr. Cumming posted in the doctors' thread -- where a stenosis just elastic recoils right back. If that is a valvular stenosis, which they nearly all are, a valvulotome could be an option as a secondary choice in a situation where the first choice, ballooning, has failed. This would also push stents further down the list of options, which is good, because stents are not good....(imo)

MarkW, I don't know if there is an FDA approved valvulotome here in the US or over in UK? They do exist, as was said already that Dr. Sinan has used one. I do not know if he frequently uses it. The one in Dr. Zamboni's patent is more perfectly designed for CCSVI usage, especially with that little basket - will wonders never cease.

If as Dr. SClafani has recently suggested, annular stenoses are more difficult to treat with ballooning than fused leaflets, perhaps when facing an annular stenosis, an IR might first balloon it (pop) and then follow with a valvulotome? That would make elastic recoil stenosis less likely! But thrombosis more likely. I think.
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Postby IHateMS » Mon Mar 14, 2011 1:18 pm

sara-sama

sorry for your loss.

our neighbor/friend died in january bfrom als. horrible disease.
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Postby sara-sama » Tue Mar 15, 2011 7:23 am

IHateMS wrote:sara-sama

sorry for your loss.

our neighbor/friend died in january bfrom als. horrible disease.



Thanks (IHateMS)

yes , it is horrible disease.
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