IVEC / ISVS this weekend

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

IVEC / ISVS this weekend

Postby Cece » Wed Oct 26, 2011 7:46 pm

How do we keep track of all these conferences brought to us by the letter 'I'?

This weekend in Milan, there is the IVEC (International Vascular Endovascular Course) joint conference with ISVS (International Society for Vascular Surgery). Some of the top CCSVI researchers will be there, including these guys:

http://www.unimib.org/ivec/Scientific_P ... C_2011.pdf

IVEC/ISNVD Joint Session on CCSVI

President: Paolo Zamboni - President ISNVD: International Society for
Neurovascular Diseases

Chairperson: Carlo Setacci - President SICVE: Italian Society for Vascular &
Endovascular Surgery

93. 11.43-11.50 Rationale of CCSVI Treatment
Paolo Zamboni (Ferrara, Italy)

94. 11.51-11.58 Doppler Ultrasonographic Screening for CCSVI
Stefano Bastianello (Pavia, Italy)

95. 11.59-12.06 Jugular Venous Wall During CCSVI and Therapeutic Implications
Matteo Coen (Geneva, Switzerland)

96. 12.07-12.14 Intravascular Ultrasound for Diagnosis and Treatment Planning in
CCSVI Salvatore ja Sclafani (New York, NY, USA)

97. 12.15-12.22 PTA of CCSVI: Hardware, Results and Problems
Donald B. Reid (Glasgow, Scotland)

98. 12.23-12.30 Neurological Evaluation of PTA Outcome
Giovanni Meola (Milan, Italy)

12.30-12.40 Discussion, opened by: Mohan Adiseshiah (London, UK)

Can Dr. Zamboni cover the rationale of CCSVI treatment in only seven minutes? While our veins are complex, the concept of CCSVI is fairly straight-forward.

Dr. Bastianello is covering doppler ultrasonographic screening for CCSVI. I am not sure if there's anything new to be said on the subject. Right now I don't trust a negative ultrasound to accurately predict that no CCSVI will be found on venogram or on intravascular ultrasound, and a lot of studies are being done using the noninvasive doppler ultrasound to determine who has CCSVI, and it has led to such variable results.

Dr. Coen is discussing the jugular venous wall during CCSVI and therapeutic implications. This is interesting in light of our many discussions that often the wall of the vein is healthy, and it is the valve that is abnormal and in need of treatment. My concerns with the venous wall itself is that it not get overstretched during treatment, because of the potential for scarring and clotting. I'd love to hear this one too.

Our own Dr. Sclafani will be discussing the use of intravascular ultrasound for diagnosis and treatment planning. We know that he uses IVUS to identify the intraluminal abnormalies within the veins. This can mean valves, septums, membranes, cobwebs, spiders (er, arachnoid granulations....) The most common finding is abnormal valves, but CCSVI is nothing if not varied. For treatment planning with IVUS, we know he uses the exact measurement from IVUS to choose the balloon size, and that the choice of balloon size is often what determines whether we will be undertreated with a too-small balloon; or over-treated with a too-large balloon that could result in clotting or scarring; or treated just right with an rightly sized balloon. It's very Goldilocks, only with our veins at stake.

Dr. Reid of EHC will talk about Percutaneous Transluminal Angioplasty (PTA) of CCSVI, in regards to hardware, results, and problems. I have not seen any presentations by Dr. Reid, and he has done a high number of procedures by now, so I would be very interested in what he has learned. For hardware, I would have to double-check to say for sure but I think that he uses cutting balloons and IVUS but not high pressure balloons. For problems, a major problem of PTA anywhere in the body is restenosis, or they wouldn't have needed to invent stents. Complications like clotting are another possible problem.

Dr. Meola's presentation looks fascinating as well. The neurological evaluation of angioplasty outcome? How do we improve, neurologically, after a procedure? What are the best ways to measure that? EDSS, MRIs, MSIS?
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