This Is MS Multiple Sclerosis Community: Knowledge & Support

For many patients, angioplasty is NOT in their best interest
By Jenny Thompson on 11/19/2010 "The landscape of medical history is littered with procedures not in the patient's best interest."

That's not just me saying that. It's actually a quote by an official from a Michigan hospital talking about using balloon angioplasty to place a stent in an artery.

Your doctor will probably describe angioplasty as "routine." But when you consider the full range of this routine (including drugs you'll be required to take), you can't help but wonder if it's really in your best interest.

Perception vs. reality

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...

Unfortunately, that message hasn't trickled down to patients.

In a recent Annals of Internal Medicine study, researchers surveyed more than 150 angioplasty patients and 17 cardiologists.

Nearly 90 percent of the patients said they believed the procedure reduced their heart attack risk. And almost three-quarters said they believed they would have a heart attack within five years without the angioplasty.

Compare that with these striking responses from cardiologists...

More than 60 percent said they believed that angioplasty benefits were simply to relieve symptoms--nothing more. And most amazing: When given two hypothetical scenarios where angioplasty provided no benefits, more than 40 percent of the doctors said they would still go ahead with the procedure!

Vicious cycle

Relief of symptoms such as shortness of breath is an important benefit for some angioplasty patients. But it might be difficult to talk many of those patients into having the procedure if they knew their heart attack risk would remain unchanged.

And, even worse, that they would have new risks to consider...

These days, stents are "drug-eluting." That is, they're treated with a drug that reduces scarring and inflammation of the artery that's sometimes caused by stent insertion.

But drug-eluting stents sometimes cause blood clots.

Yes, you read that right--your stent that is being inserted specifically to reduce your risk of blood clots might actually CAUSE a blood clot!

But don't worry. Your doctor already knows that. And that's why he will prescribe a blood thinner like Plavix or Effient. Unfortunately, all blood-thinning drugs increase the risk of bleeding. In fact, Effient comes with a black box warning about the risk of death due to "unexplained or excessive bleeding."

So in the end, this "routine" procedure can turn out to be fairly complicated. And for many patients, it becomes down-right dangerous--and provides no real benefit.

If your doctor suggests angioplasty, ask why. Unless it's to relieve some serious symptoms, figure out if there's a better option for you, like one that actually decreases your chance of having a heart attack.

so, more research and ways of preventing vein damage etc. has just got to be solved. the path is there we know that. just more to consider than some of us realized. but, hopefully soon.

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.

We can screw up a vein in someone's leg, not a big deal, but how about a vein that carries blood from someone's brain.

We can screw up a vein in someone's leg, not a big deal, but how about a vein that carries blood from someone's brain.

griff, the point of the article is still the point be it veins or arteries. i agree with you. no bashing just pointing out things. that maybe some of us wish we would have researched better. because early on i was takeing it that-ok if i restenose they just go back and open it up again-no big deal. WRONG it is big deal if your vein becomes so damaged you loose it. now, you not only have these symptoms they named ms but you could be in bigger trouble and not a quick departure from this world as a heart attack but something else added to your misery.[/

And this is what many people think: Why live with such an important insufficient vein? Why not try to bring the cerebral flow and perfusion back to normal?

You cannot compare arterial TPA of very small coronary ARTERIES with large venous procedures. S
Size, pressure and wall anatomy are completely different.

After five years, researchers found no significant difference in rates of death, heart attack, or other major events.

IRs have no experience with IJVs and azygos

The organ affected is the most important thing to consider. We are talking about the BRAIN !

CCSVI causes hypoxia. Hypoxia is smothering. Of course in CCSVI it is low level but it is still oxygen deprivation of the brain. Then combine it with other things that have been proven such as HYPO-Perfusion.

Hypoperfusion means the brain is not getting adequate fuels. Besides OXYGEN, it includes GLUCOSE and all the other things that cells need such as hormones, vitamins, etc. Also the metabolic waste products build up, these are not good for brain cells to function.

I try to weigh what other IRs are saying too. How can we know that hypoperfusion is present in our case? Many of them say that collaterals can take some of the role of IJVs and azygos. Another thing is the Buffalo study. Why do many healthy people have CCSVI?

First I must mention that BUFFALO (BNAC) included family members. These are birth defects, most probably no different than inheriting your mom's wavy hair, you might have gotten her CCSVI too. As CCSVI goes on E1 is produced and causes fibrosis and hypertrophy which make it get worse.

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Hypo perfusion has been proven. Slow transit time causes hypo perfusion. All CCSVI patients have hypo perfusion to varying degrees as to the location and extent.

MAKE SURE STUDIES USE VENOGRAMS TO PROVE OR DISPROVE CCSVI ( not dopplers or MRV) and validation of statistics is done completely and the title of the study matches the results I have seen quite a lot of SKEWING study data with CCSVI from them

Also, as much as I love my daughters IR, he is a plumber. They are not
vascular internists, and there is more to CCSVI than plumbing. Learn about