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.
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.