For those who are unsure of Endovasc's identity, he previously posted here in January with the signature as Michael Arata MD:
I have no reason to doubt that he is Dr. Arata.
Full dose anticoagulation has my support over antiplatelets or nothing at all. I also look for doctors that do not keep doing the same thing but adjust their protocols as they learn. It is good to hear that Synergy is doing this.
When you say a third of patients have no stenosis, does this include valvular stenosis?
One of the suggested uses of IVUS is to accurately measure the size of the vein in order to select an appropriately sized balloon. It is also said to be of use in finding valvular stenosis in the azygous that cannot be seen on flouroscopy alone. I must disagree that the use of IVUS deviates the focus away from flow and toward anatomy. It is a tool that gives more information on what is going on in the veins, including what is causing the flow abnormalities; with more information, better decisions can be made.
Your position on the iliac and renal veins is very different from what we have more commonly heard. Thank you for sharing it, it is good to know both sides of these debates. I would argue that, if CCSVI is about flow, then the impact of stenoses in the iliac and renal vein on the flow in the azygous cannot be denied.
Thank you for all your reponses, they are indeed helpful.