I have yet to watch the vids but am extremely interested. Where is the time for everything! The vids can be found in individual threads here on TiMS or if you want to watch them one after the other, they are compiled on Dr. Sclafani's facebook page.
http://www.facebook.com/Sal.Sclafani.MDI bumped this up because I ran across this summary of what was discussed at the AAC symposium in July.
http://ccsvicoalition.org/resources/ccs ... big-issuesQuote:
More specific to CCSVI, it was clearly evident that with the growing number of procedures completed worldwide, standards of best practice and protocols are emerging. Having gone from an experimental procedure it has now entered a definitional stage that will see procedural standards emerge as well as patient selection standards. New procedural developments include the use of Intra Venous Ultrasound (IVUS) as well as some intriguing uses of stem cell therapy. Also, there was a call for more standardization and greater use of imaging before during and after the procedure. As to patient selection, this relates to the growing knowledge that there are various types of stenosis and each might require different treatment regimes or even no treatment at all. Restenosis treatment selection also was discussed. In summary, it is obvious that CCSVI procedural understanding is maturing and growing in sophistication.
Lots of interesting points here. I am not sure if procedural standards are emerging as a consensus. Maybe I am too close in, I am thinking of the differences that I know between different IRs techniques. Dr. McGuckin's patients, for example, tend to report him having found stenoses in multiple different veins. I keep hearing that they had five or six stenoses ballooned, which to me says that he may be using a broader definition of a stenosis than some other IRs, and also that he is including more veins. Some IRs use IVUS, some don't balloon high-up in the jugular. I think across the board the use of stents has come down, as has the use of extra large balloons. I would like to see the use of IVUS as part of standard procedures.
Patient selection! This has been worrisome to me, because I want all patients to be treatable, all stenoses to be fixed, and everyone to have a really good outcome. In the real world, this is not possible. But how do they determine who not to treat? We've already been privy to the debate over whether or not renal occlusions should be treated. Some IRs do not check for May Thurners. Then there is patient selection for re-treatment!
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