OPINIONS DR ARATA & DR HEWITT

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

Postby PointsNorth » Tue Jul 05, 2011 10:24 pm

If IVUS is NOT being used I think that avg. procedure is around 45min-1 hour. With IVUS around 2 hours?

PI (Now "Synergy" for CCSVI) has done well over 1000 treatments and their batting average seems pretty good. Altho I think in recent days I've convinced myself that IVUS is a no-brainer. It adds cost to an already costly venture, but the potential benefit outweighs incremental cost.

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Postby MrSuccess » Tue Jul 05, 2011 10:33 pm

How can the price of IVUS be lowered ?

More interesting ..... are those treated using IVUS .... getting better results ?

This is what a Trial should reveal.

And what is Dr. Zamboni's opinion on IVUS ?

When is the next assembley of CSSVI medical professionals ..... apart from Dr.S's Brooklyn meeting ?


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Postby civickiller » Tue Jul 05, 2011 10:52 pm

Cece wrote:Enough of my friends have tried it that I will be giving it a try too. Just not this year, because I feel I've had enough radiation this year from the procedures, and UCC does require xrays? I also need a bit of a break. But next year, I'll give it a try.


yes unfortunetly you do need to get xrayed. only problem is that it can take a while till your atlas holds its correct position. mine took 7 months to hold, going once a week. now i do monthly visits.

if i remember correctly cece, you already had the surgery. i work on the policy if it aint broke dont fix it. if your doing fine then idk if i would recommend ucc. if uve restenoised and r getting worse then yes do ucc
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Postby Thekla » Wed Jul 06, 2011 5:49 am

IVUS sure seems to be a deciding factor, at least for me, at this time. It sounds like the benefits are a thousand times worth the cost but I'd love to see some data to back this up.

I am also very curious about the anticoagulant/antiplatelet treatments. What are the results? There is so much diversity in protocols, what is working? What is unnecessary?
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Postby AlmostClever » Wed Jul 06, 2011 6:02 am

Cece wrote:
Cece wrote:
I personally average 20 CCSVI procedures a week. I have been doing it for over a year. If not the most, certainly one of the most experienced in the world.

Those are good numbers.

I disagree with myself, on second thought. 20 per week, if he is working five days a week, means four procedures a day. He may not be spending enough time on each patient.


He personally did my procedure. While I can't remeber how long he worked on me, I can tell you that he is a work horse and is at the clinic ALL day. When I met him the afternoon prior to my procedure, he seemed exhausted!

The clinic is state of the art and he had a very good support crew.

Also, VERY punctual! (or they try to be!)
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Postby dania » Wed Jul 06, 2011 6:54 am

Cece wrote:
Cece wrote:
I personally average 20 CCSVI procedures a week. I have been doing it for over a year. If not the most, certainly one of the most experienced in the world.

Those are good numbers.

I disagree with myself, on second thought. 20 per week, if he is working five days a week, means four procedures a day. He may not be spending enough time on each patient.

He takes as much time that is needed. With me, he tried twice, on 2 different days. The first took a few hours and the second was almost as long. This compassionate doctor takes the time that is needed to do the job. He is NEVER in a rush.
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Postby Cece » Wed Jul 06, 2011 7:15 am

PointsNorth wrote:If IVUS is NOT being used I think that avg. procedure is around 45min-1 hour. With IVUS around 2 hours?

PI (Now "Synergy" for CCSVI) has done well over 1000 treatments and their batting average seems pretty good. Altho I think in recent days I've convinced myself that IVUS is a no-brainer. It adds cost to an already costly venture, but the potential benefit outweighs incremental cost.

PN

You're right, I forgot about the lack of IVUS.

I don't think the cost is incremental on the doctor's side. $100,000 for the machine; $600 per single use IVUS catheter that needs to be tossed afterwards; and time added onto the procedure so that fewer procedures are possible in a day. Charging more for the procedure because of IVUS may also reduce the number of self-paying patients, primarily Canadians, who come through the door.

I agree though that as a patient IVUS is a no-brainer. Dr. Arata is saying that patients will do best if they only have one procedure? I am not sure I agree with that but if there is to be only one procedure, using IVUS would increase the odds of the one procedure being a success.

Dr. Arata posted here on TIMS once, perhaps he might stop by to share his thoughts on the benefit vs cost analysis of IVUS?
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Postby MrSuccess » Wed Jul 06, 2011 8:07 am

I see. Looks like a large but wise investment [ IVUS ] for those involved
in CCSVI or other treatment.

I have viewed the numerous IVUS images posted here on TIMS , and am clueless as to what to make of them .... I must be daft .

However , I trust the judgement of those that rave about IVUS.

We do need IVUS 101 .... or IVUS for dummies ..... to show up here on TIMS.

I think IVUS combined with the neck-collar thingamajig ...... will be the way to go.

Mr.Success wonders what other marvels of medical equipment await around the corner........



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Postby Cece » Wed Jul 06, 2011 9:54 am

MrSuccess wrote:We do need IVUS 101 .... or IVUS for dummies ..... to show up here on TIMS.

There will be a talk by Dr. Sclafani on IVUS at the CCSVI symposium next
Friday. I don't suppose you're in NY, MrSuccess?
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Postby civickiller » Wed Jul 06, 2011 1:07 pm

MrSuccess wrote:I see. Looks like a large but wise investment [ IVUS ] for those involved
in CCSVI or other treatment.

I have viewed the numerous IVUS images posted here on TIMS , and am clueless as to what to make of them .... I must be daft .

However , I trust the judgement of those that rave about IVUS.

We do need IVUS 101 .... or IVUS for dummies ..... to show up here on TIMS.

I think IVUS combined with the neck-collar thingamajig ...... will be the way to go.

Mr.Success wonders what other marvels of medical equipment await around the corner........



Mr.Success


i feel the exact same way when looking at a ivus picture
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Cece. Re Synergy

Postby pollyanna » Wed Jul 06, 2011 3:35 pm

I would not return to see Arata.
No collaborative research.
Does not do renals or ileac.
Way too rushed.
It looks like he treats by symptoms(?) and percentages.
That is unsafe in my mind.
I think he was on top at one time.
He has lost ground.
Does no collaborative research.
His business plan is looking like, fast money.
I urge everybody to research very carefully.
Before you book with somebody, get their data.
IVUS makes sense.
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Postby Endovasc » Wed Jul 06, 2011 9:27 pm

Ok folks here I am. I will try and respond to most of the discussion. Perhaps best if I break up and use separate subjects.
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Research

Postby Endovasc » Wed Jul 06, 2011 9:32 pm

Synergy is committed to research. We have been working with Dr. Haacke on several topics. The first paper has already been accepted for publication. We are in process of hiring a PhD. to lead our research efforts. We will be one of the first, if not only private group with a PhD. member investigating CCSVI.

We are very selective in the collaborative efforts we make. Quality research not quantity matters.
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Postby MrSuccess » Wed Jul 06, 2011 9:45 pm

I appreciate your presence here , Dr.Arata ?

Are you ever going to be busy ..........




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Renals and iliacs

Postby Endovasc » Wed Jul 06, 2011 9:50 pm

The renal and iliac veins in no way shape or form cause CCSVI. Myself, Drs. Simka, Siskin and Moguel differ in our approach to CCSVI. However we are the four most experienced physicians in the world. Having performed the procedure approximately 500 times each. None of us go near a renal or iliac vein.

Standards of care are an issue with venogram or worse yet iliac or renal vein angioplasty. In the US if you perform an invasive procedure on a patient symptoms must be present that can be explained by the system being evaluated. If symptoms are absent it is clearly a violation of standard of care. This is just doing a diagnostic venogram. Venous angioplasty on an iliac or renal vein absent symtoms could be construed as battery.

I challenge any physician in the world to show me a single case of CCSVI caused by iliac or renal veins.

As physicians we need to educate each other and clean our own house. Renal and iliac venograms and especially angioplasty on CCSVI patients needs to stop and stop now. Our collective credibility is at stake.
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