CureIous wrote:The question is not really about finding the stenosis, as much as what to do with said stenosis once they are found, if Dr's are treating stenosis one day by angio or whatever, only to have restenosis occur on a regular, and unaffordable basis, then what's the point? We know so little about restenosis rates from certain clinics (unnamed), but it does happen much more frequently than you know.
Not only that, but the narrowings MOVE. So now what? Monthly angioplasties?
We tried obliterating the valves. Meh, the stenosis come back. We chase the variable little buggers around like petulant children. We angioplasty over and over until the veins can take no more, I speak of those that have fallen between the cracks, the hopeless, scarred an untreatable.
Yet scanning techniques are the only issue when it comes to evaluating clinics?
I think not. Talk with the woman I talked with, personally, this past weekend. They paid their money, did the procedure, got their couple of months of WOW.
Right back to square one, I saw the UT scans, before, and after, on a regular basis.
I will tell you to keep in mind stenosis is variable. A bad spot today is great tomorrow, I've seen the numbers. Shilling patients at 10-15k a pop for a variable condition, is not sustainable. You eventually run out of green recruits.
Keep this in mind all you Drs, we are guinea pigs, but with limits. Bad news travels just as fast as the glory stories. I detest any Dr., regardless of his title, experience, or accolades, using us MS/neuro patients to fulfill his/her own need for whatever career goals.
Cureious, I would disagree with you about roaming stenoses. Transient stenoses are not true stenoses they are most commonly muscular compressions that do not really respond well to angioplasty and may not need treatment at all. "restenosis" at different points in the vein can truly happen if angioplasty is done at an incorrect location with too large a balloon, thus forming a new stenosis.
almost all the restenoses I have seen have been exactly at the site of the original stenosis, that is most commonly at the valve. These restenoses are most likely caaused by
1. inadequate angioplasty
2. annulus injury due to too large a balloon
3. thrombus forming around the angioplastied valve leading to adhesions
4. a dominant collateral that diverts blood away from the normal pathway
6. recoiling valve leaflets, and i cannot figure out what causes this or how to predict it.
I cannot comment about others, but i work with wonderful doctors who are trying to understand ccsvi, causes, treatments, diagnosis.
Medical care costs are expensive and without government and insurance support, all modern medicine would be unsustainable.
In the US patients with kidney failure require repeated angioplasty to keep their arteriovenous fistulas open for dialysis. Without the government's decision to include dialysis care for all, many people would have died for lack of insurance to support this expensive treatment.