Treating CCSVI seen on MRV but not on venogram?

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

Treating CCSVI seen on MRV but not on venogram?

Postby Cece » Mon May 16, 2011 7:49 am

From Arlene Hubbard's notes on the Hubbard conference:
http://www.facebook.com/notes/arlene-pe ... 4524950517
Justin Gooding...CCSVI venography and intervention

He discussed the history of CCSVI and the pathophysiology...delayed perfusion, inflammation, iron deposition. He uses the MRV flow data as a map to localize where he is going during the venoplasty. This was discussed by others as being essential. Sometimes the IR cannot detect a problem but the MR flow data is showing a problem the IR will follow the map of the flow and treat an area not detected with venography.

What do you think of this idea? It's taking the information from MRV over the information from the venogram, so treating an area that looked bad on MRV but doesn't look bad on the 'tarnished gold standard' of venogram.

I ask, where is the IVUS, for these situations? Why treat blindly when you can see with IVUS? Am I wrong?
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Postby WeWillBeatMS » Mon May 16, 2011 8:12 am

Cece,

You should repost this on the IVUS thread by Dr Cumming where both he and Dr Sclafani answer questions.

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Postby Cece » Mon May 16, 2011 9:27 am

:oops: I wasn't really asking, more pontificating that IVUS is best.

Though I'd welcome the good doctors' opinions as well.

It seems to me that, the higher value you put on our jugulars and azygous veins, the less you want to risk ballooning unnecessarily because there can be damage to the vein. I place a very high value on jugulars. So,that lends itself to conservative treatment.
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