Study is flawed, says Dr Hewett, not a gold standard study

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Study is flawed, says Dr Hewett, not a gold standard study

Postby Cece » Thu Apr 14, 2011 4:49 pm

Canadian Dr. Joseph Hewett has been doing neck vein angioplasty for about 15 years. He now performs balloon angioplasty on people with MS in southern California. He says the latest study has flaws and that he will continue doing the surgery until there's a "gold standard" study.

www.cbc.ca/news/health/story/2011/04/14 ... ewett.html

'2 doctors react to MS study'

I'm with Dr. Hewett on this one.

It is worth watching the 2 minute interview with Dr. Hewett. Here are my notes from it:

He saw two issues with the study
1 – data was doppler ultrasonography which is not the gold standard. Gold standard is the (catheter) venogram.
2- the control patients were relatives, this distorts the value of the data, these relatives may have had MS

A more valid study is Dr. Haacke's looking at a more general population (presented in italy) and 8% of people had CCSVI.

They have treated 700 patients at PI (!!) with encouraging results. He personally has 15 years jugular venous angioplasty (for what diseases, he did not say, and I am curious). In his opinion the results are not possibly placebo effect. Mounting body of evidence is that the procedure plays some role in patients with neurodegenerative diseases.
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Postby MrSuccess » Thu Apr 14, 2011 7:26 pm

Open message to Dr. Jock Murray.......

... I see you go to great length to mention that so-called '' healthy controls '' make up 25% of the people in the study. And frown.

Are you confident that these HC's are free from any Internal vein problems ? Please read Dr. Sclafani's IVUS reports.

Are you confident that the HC's have correct blood flow ?
Please read Dr. Zamboni's neck collar report.

And finally ...... the Neurology community seems to like to use brain lesion counts..... as an MS scorecard ...... and the gateway to their lucrative drug prescriptions.... :twisted:


Correct me if I'm wrong ....... but according to the NMSS web page ...... on autopsy ...... people that lived a life - without ever reporting having any MS symptoms - were discovered to have brain lesions.

There are no easy answers.




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Postby Liberation » Fri Apr 15, 2011 4:54 am

MrSuccess wrote:And finally ...... the Neurology community seems to like to use brain lesion counts..... as an MS scorecard ...... and the gateway to their lucrative drug prescriptions.... :twisted:


Correct me if I'm wrong ....... but according to the NMSS web page ...... on autopsy ...... people that lived a life - without ever reporting having any MS symptoms - were discovered to have brain lesions.

Mr. Success


Yes, you are right. People without having any major symptoms might have brain laesios. Even neurologists say that MRI diagnostics has changed the MS landscape. There are lots of people who might have a minor migrain and who have never been considered as MS patient, but with MRI we identify them as one of them.

According to some honest neurologists the biggest problem is that we do not even know what is MS.
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Postby 1eye » Sat Apr 16, 2011 7:35 am

I think the problem might be all those healthy controls who may not in the long term turn out to be so healthy. Especially the ones with CCSVI. Who is going to pay all those hospital bills? Especially if they take Jock's advice and don't get treated? Huh? Who? Not me.
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Postby PCakes » Sat Apr 16, 2011 8:02 am

Liberation wrote:...People without having any major symptoms might have brain laesios. ...


I was told at diagnosis, that research through autopsy of the elderly reflects that approx 60% of people will develop lesions as they age. I've felt from the start that MS is like an accelerated aging process. What else happens as we age?.. impaired circulation. It fits. Damn it. Fix it!
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Postby MrSuccess » Sat Apr 16, 2011 10:53 pm

Cece - a good summation of Dr. Hewett's interview ..... as you posted ....
the low number - 8 % - is certainly interesting . Well done Dr.Haacke. :!:

..... and 700 people treated ..... and counting .....

this video is a must see ..........




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Postby Cece » Tue Jun 14, 2011 10:56 am

www.dailyheraldtribune.com/ArticleDispl ... ?e=3169729
Hewett warned CCSVI is by no means a cure for MS, but an approach applied to relieve some of the debilitating symptoms of the disease. Hewett has seen a 70 to 80% success rate in the relief of symptoms in some patients.

"Sometimes it's small, sometimes it's quite dramatic," he said.

The procedure is based on the medical theory that multiple sclerosis is caused by narrowed or blocked veins in the neck, causing an excessive tension in the veins.

"This venous hypertension causes a breakdown in the barrier that separates the blood from the brain inside the brain," explained Hewett. "Red blood cells can then egress and exit, or leak, into the brain from the small veins in the head."

According to the recent theory, the red blood cells' hemoglobin, containing oxygen and composed of iron, then cause a reaction in the brain characteristic of a person with MS.

"Effectively, the blockages are causing abnormal deposition of iron in the brain," continued Hewett. "When that iron is there, it causes the body to form an inflammatory response to this foreign invader, and it's that inflammatory response that could cause demyelination and the scars, or plaques, that are commonly associated with multiple sclerosis."

Dr. Hewett again, explaing CCSVI.
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Postby 1eye » Wed Jun 15, 2011 3:54 pm

Now that we know, reasonably for certain, that the collateral veins that grow in our necks are a response to stenoses which prevent adequate flow in the prone posture, and can surmise that a lot of the damage being caused in our brains and spines is happening in that posture;

And we also have found out that more people than we thought (the number Dr. Zamboni at first reported as 0 percent) have CCSVI, which probably means they are not getting enough oxygen when lying down;

And we didn't know these things before;

And studies of Hyperbaric Oxygen therapy have been inconclusive;

And studies of Hyperbaric Oxygen therapy may have been done in the prone posture;

And before and after studies of CCSVI venoplasty indicate that there is a definite hypoxia involvement;

Should we not consider the possibility of Hyperbaric Oxygen therapy as a post-treatment adjunct to venoplasty for CCSVI, to see whether improvements can be made in recovery from hypoxic damage?

Perhaps the studies of HBO therapy on people with "MS" were inconclusive precisely because they had not had any prior treatment for CCSVI.
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Postby Cece » Wed Jun 15, 2011 4:32 pm

if you think of the effects as CCSVI as ongoing lowgrade strokes, then it makes sense that HBOT would work better once the ongoing strokes have stopped.
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Postby 1eye » Wed Jun 15, 2011 8:51 pm

I think it's bound to fail if a key part of the problem is hypoxia due to circulation problems and you don't fix that first. Especially if the stenosis is in the jugular and you do the therapy lying down.
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Postby CureIous » Wed Jun 15, 2011 10:11 pm

MrSuccess wrote:Open message to Dr. Jock Murray.......

... I see you go to great length to mention that so-called '' healthy controls '' make up 25% of the people in the study. And frown.

Are you confident that these HC's are free from any Internal vein problems ? Please read Dr. Sclafani's IVUS reports.

Are you confident that the HC's have correct blood flow ?
Please read Dr. Zamboni's neck collar report.

And finally ...... the Neurology community seems to like to use brain lesion counts..... as an MS scorecard ...... and the gateway to their lucrative drug prescriptions.... :twisted:


Correct me if I'm wrong ....... but according to the NMSS web page ...... on autopsy ...... people that lived a life - without ever reporting having any MS symptoms - were discovered to have brain lesions.

There are no easy answers.




Mr. Success



While I would like to see my brain lesions gone at the 2 year follow up, I'm sure they are still there. Hmph, go figure. They is what they is, and my life is what it is, G*R*E*A*T. So I guess the lesions themselves, truly are NOT an indicator of any one individual's disease condition, and/or their particular level of disability.

Yet as you say, that alone (lesion load/counts) is what the pharmies use to justify shooting us up with 30-50k/yr worth of drugs? I mean take them if you like, you got the bucks or the insurance and want to cover the basis, fine by me.

But for the rest of us poor broke working stiffs, we don't have such luxuries as that betting on a total crap shoot... for nothing more than "reducing lesions". How about cutting those lesions off at the source now THAT'S a good thought...
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby 1eye » Thu Jun 16, 2011 8:18 am

I have seen your MRIs, CureIous, and I think your lesions are slowly going away, IMHO. They are not markers of disability, so as you say, if not, you can live with them. I think gadolinium-enhancing ones are supposed to be new lesions. Lesions can be seen on ordinary MRI as bright spots, because of the density of the tissue and its water content. Black holes are places where there is no water-filled tissue left, not lesions, but actual holes. I have lots of those. I assume retraining if possible is necessary for them.

I think we might be forgetting that Dr. Zamboni actually measured lesion load in his studies, and found that it was reduced after venoplasty. This fact is being ignored by those who are doing studies now, but it is one of the key points in the Angioplastyforall lawsuit. Being that a lot of the $10B autoimmune DMD house of cards depends on it, it is probably a very touchy subject for some people. However, the destruction of the blood-brain-barrier, which *is* a hallmark of "MS", produces gadolinium-enhancing lesions.

That is because the MRI marker, gadolinium, leaks at the site of veins which are central to these lesions, across the blood-brain-barrier, and nowhere else. This leakage provides the mechanism for imaging the lesions in the first place. Once the angioplasty has been performed, there is enough oxygen in the venous blood which still reaches these sites, to heal the lesions, and gadolinium no longer leaks across at those sites.

I believe that with the addition of hyperbaric oxygen therapy these lesions will disappear completely, after successful venoplasty treatment for CCSVI.
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