For many patients, angioplasty is NOT in their best interest

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

Postby Cece » Tue May 03, 2011 6:17 am

IRs are the guys in charge of the treatment itself. I think this puts them first and foremost in terms of what we need and what's best for pwMS. For figuring out all the cascade of effects and what's been going on in our veins and brains, that takes the team of specialists across disciplines. (It has been something to see the establishment of ISNVD and all that was accomplished at their first conference.) That will take time. I am very interested in all those effects and I don't yet understand things like endothelin-1 as much as I'd like to. In the meantime while there are patients going forward with treatment, my attention is on the IRs who are providing that treatment and working hard to make it safer and more durable and more successful. :)
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Postby griff » Tue May 03, 2011 7:32 am

Cece wrote: IRs are the guys in charge of the treatment itself. I think this puts them first and foremost in terms of what we need and what's best for pwMS. For figuring out all the cascade of effects and what's been going on in our veins and brains, that takes the team of specialists across disciplines.


I agree. As we sometimes experience miraculous recoveries after operations and sudden deteriorations when veins collapse, I think there is much more behind than what we see today. In either case, it would be important to know what is going on to avoid major damages and to also understand what causes the improvement. This is I think beyond IRs. As long as we do not know what are the other connections, we would need specialists from different fields.

In a different situation, my understanding is that if someone has a heart problem, he goes to a cardiologist and he might send his patient to the IR to do the plumbig job. In our case it should be something similar, but instead of cardiologist we might need someone else.
Last edited by griff on Wed May 04, 2011 12:47 am, edited 1 time in total.
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Postby 1eye » Tue May 03, 2011 8:14 am

In a different situation, my understanding is that if someone has a heart problem, he goes to a cardiologist and he might send his patient to the IR to do the plumbing job. In our case it should be something similar, but instead of cardiologist we might need someone else.
Well, you send out your plumbing jobs, do you?

Interesting. I had no idea there was such a hierarchy among MDs. So in effect IRs only 'borrow' patients until they give them back to the Main Doc? Just for subcontracting stuff, right? And is there an accepted industry scale for this subcontract work?

That's the real problem, isn't it? If somebody can suddenly treat something that wasn't treatable before, you have a situation of uncontrolled market freedom and a whole lot of people who, until now, didn't make many headlines, as much as most surgeons, acting like capitalists. They are trying to actually make money off of something doctors often say they do without being able to deliver: relieving suffering. Because they can often deliver, the money is flowing. Some people don't like seeing that happen.

So let's call the plumber, before this thing overflows...
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'MS' is over - if you want it
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Postby griff » Thu May 05, 2011 12:21 am

This thread was intended to start a discussion on the potential future effectiveness of angioplasty. Since, we did not have enough info on the angioplasty of IJV and azygos I posted an article on angioplasty of arteries for discussion.

You have to accept the fact that many of us got into a worse condition after angioplaty than we were before so I think our opinion should be taken into account as well if we try to find an answer to the effectiveness of angioplasty.

I thank Cat's comments, because I see her comments were very thoughtful.
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Postby NHE » Thu May 05, 2011 10:05 am

fernando wrote:
Asher wrote:Great post! And this is what dr Sclafani will not tell us. There was/is a lot of ranting about the neuro/pharma 'conspiracy'. Well, I wonder what effect CCSVI has had on the net value of some interventional radiologists? :lol:


This is incorrect and unfair as anyone who has been reading Dr. Scalfani's posts could say. Not to mention those who were intervened by the Dr.


Indeed! In moving from his hospital position to American Access Care, Dr. Sclafani has stated that he has taken a notable reduction in his salary. He has done this since he believes that he can help people with MS. I suspect that there are very few people in this world that would follow suit.


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Postby bluesky63 » Thu May 05, 2011 10:43 am

Hi griff. :-) I am not sure you had a chance to see my question on your other thread, but I had a sincere question. Where in Europe do you live? What is your native language? Thank you. :-)
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Postby griff » Fri May 06, 2011 12:57 am

bluesky63 wrote:Hi griff. :-) I am not sure you had a chance to see my question on your other thread, but I had a sincere question. Where in Europe do you live? What is your native language? Thank you. :-)


I live in Croatia. So, I can not speak Italian and also forgive me that my English is not perfect either.
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Postby griff » Sat May 14, 2011 2:10 am

First, let's look at a realistic assessment of the "benefits" in having a stent inserted in an artery.

You may be surprised by this 2009 New England Journal of Medicine study that followed nearly 2,400 patients. Half the subjects received drug therapy (statins, aspirin, beta- blockers, etc.), while half received drug therapy and angioplasty.

After five years, researchers found no significant difference in rates of death, heart attack, or other major events. And this research confirmed similar results of a 2007 Department of Veterans Affairs study.

No significant difference. Hmmm...



It is interesting that no IR doing CCSVI operations have refuted this data. So, I am still curious whether we face similar prospects with angioplasty of IJVs and azygos....
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Postby Cece » Sat May 14, 2011 6:28 am

Different patient population, different disease, different type of blood vessels.
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Postby 1eye » Sat May 14, 2011 6:53 am

Of course, if you are lying in a very very very crowded hospital ward with nothing but a johnny shirt on and the nurses think it's hilarious to watch you spill the urine bottle on yourself because something down there isn't quite working and they have to poke you about 17 times to get a line in for the tranquilizer because they have to rip off those electrodes and you are going down for angio in an hour, and after three blood tests and an echo they told you you need it because you have had a heart attack, you are bound to remember what you read on TiMS, and heard Montel say, and read in the waiting room, and by the way didn't Colin Rose agree it was a silly thing to let them do? Sure you'll just tell them all to stuff it, you read it on the Internet, so call me a cab.

I have three stents in my chest and if anybody tells me one more time that there is no documented proof that I will not die anyway, I cannot be responsible for the mess that they will make on the floor when my chest explodes in that person's general direction.
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