discussion of Dr. McGuckin's abstract on RF of occlusions

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discussion of Dr. McGuckin's abstract on RF of occlusions

Postby Cece » Wed Sep 21, 2011 12:15 pm

http://ccsvism.xoom.it/ISNVD/Other/Abst ... guckin.pdf

Credit to newlywed4ever for posting this earlier today, in Dr. Sclafani's thread. Really interesting. A CCSVI patient with occluded subclavian and jugular veins had them successfully recanalized using radio frequency.

I can't remember, but we've discussed this before: would this also work on patients who have scarring occlusions? Or would it be best for patients with clotting occlusions?

Dr. Sclafani mentioned some possible complications, including damage to the carotid artery due to its nearness to the jugulars, which could lead to stroke, arteriovenous fistula or bleeding. Has anyone discussed this technique with Dr. McGuckin, to hear what Dr. McGuckin has said about possible risks?

It's also of note that not only did Dr. McGuckin get the vein open, but three months later the vein was presumably still open (the abstract says that MS symptoms had resolved by three months).
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby 1eye » Wed Sep 21, 2011 3:02 pm

I think the part that has had RF open it, although patent, is a very dubious vein. It will be a last option for some, but I hope I'm not among them. Glad it exists, though, as I know one person who needs something like it.

I know the procedure holds the most promise for "RR" people, but some are not hoping for a complete reversal, so much as to stay alive. I believe it can make that happen.
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby Cece » Wed Sep 21, 2011 3:08 pm

1eye wrote:I know the procedure holds the most promise for "RR" people, but some are not hoping for a complete reversal, so much as to stay alive. I believe it can make that happen.

Didn't Dr. Ponec present at the AAC patient day, from his patients, that there is no rhyme or reason as to who has improvements and who doesn't? That a young female RR patient might be expected to have the best results, but in his work, he is not seeing any predictors such as age, gender, diagnosis, etc. On the other hand, I have heard that PPMS might not be getting as good of results. It would seem to still be very much yet to be determined.
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby dania » Thu Sep 22, 2011 7:14 am

I was told even if it could, then what? My vein would probably close again, as he not be able to treat the valve. That is what my doctor told me. At the moment this treatment is best for patients with a small blood clot. Wish it work on my problem.
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby Cece » Thu Sep 22, 2011 10:12 am

I think it was Dr. Arata who said that the problem is not getting these occluded veins open, it is keeping them open. I wouldn't understate the difficulty in opening occluded veins, but hadn't understood how problematic keeping them open can be. One good thing from this abstract is that it was a fairly large clot that was successfully treated. It didn't go all the way to the top of the jugular but it did go to the mid-cervical level and then down to the brachiocephalic junction.
I was told even if it could, then what? My vein would probably close again, as he not be able to treat the valve.
I would think an opened vein might close again because damage had been done to the vein wall over the course of procedures and a long time spent occluded and the force used to open it. Even a vein that recanalizes on its own is not a healthy normal vein but it has been changed by what it's been through. I don't know what role a valve might yet play in that situation.
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby dania » Thu Sep 22, 2011 11:29 am

This is how Dr Arata thinks that valve works. Imagine a flexible garden hose... when the water is turned on the hose inflates with water. When you turn the water off the hose collapses.
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby Cece » Thu Sep 22, 2011 9:34 pm

The presence of a bad valve can cause the vein to narrow higher up, as the flow diverts off through collaterals. This narrowing has been misinterpreted as a stenosis of its own, when really it's physiological; this area of the vein is not stenotic because it can distend, if the patient's breath is held which fills up the jugulars, or if the flow is restored at the area of the valves. I think this is what Dr. Arata is describing. But I don't see why he'd assume the valve would still be functional after being unearthed from an occluded jugular, assuming he was able to get through the occlusion, or why if the valve was still functional, he would not then balloon the valve?

I'd understand better if the answer is that RF does not work when the veins are scarred down, only when it is a simpler clot without the scarring.

I think the risk profile of RF, going by what Dr. Sclafani laid out in his thread, would still be preferable to the risk profile of attempting a jugular graft for most patients. There also needs to be more knowledge about which patients are helped by CCSVI treatment and which aren't. Maybe there are patients for whom the risk/benefit analysis is more in favor of attempting a RF procedure because there is more to gain. Patients who had responded to the procedure by having improvements before losing them when the vein occluded would seem to have a lot to gain if the occlusion could be gotten through.

Does anyone know how many RF procedures in CCSVI patients that Dr. McGuckin has done? Or if he was using RF prior to using it in CCSVI?
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Re: discussion of Dr. McGuckin's abstract on RF of occlusion

Postby MrSuccess » Thu Sep 22, 2011 9:56 pm

I'm short on the details .... but there once was a strong theory put forth recently that radio frequency ... could .... be used in fighting cancer. If I remember the story correctly ,
the RF would kill the cancer cells , but not healthy tissue.

I'm recalling more of the story now ..... the gentleman inventor had cancer himself . He reasoned that RF might work based on his lifes work, in his line of work.

I think this article was in Popular Science.

I always wondered how it panned out .

[ panned out is a gold miners term , after carefully swishing the gravel in your pan for a long time ..... you hopefully are rewarded with some gold nuggets or flakes ..... thus ...." it panned out " if not .......you say ..."well , it didn't pan out" . ]

RF holds some promise . maybe it does have medical applications .....


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