Dr. Dake used MRV- magnetic resonance venography. This is a much safer way to see the veins and stenosis, and allowed us to skip the TCD doppler step and go straight to the veins.
Quote:
The clinical applications of MRV include diagnosis of deep venous thrombosis, for which MRV is the “new gold standard,” evaluation of chest and upper extremity veins for venous access, differentiating bland from tumor thrombus, diagnosis of superior vena caval syndrome, identification of superior vena caval invasion or encasement by lung or mediastinal tumors, diagnosis of the Budd-Chiari syndrome, diagnosis of caval anomalies such as persistent left superior vena cava and interrupted inferior vena cava, and identification of the presence and cause of obstruction or occlusion of the brachiocephalic, subclavian, and jugular veins.
Two MR techniques used for venous imaging include two-dimensional (2D) time-of-flight (TOF) MR angiography and three-dimensional (3D) gadolinium enhanced gradient-recalled (GRE) imaging. TOF is a widely used, noninvasive technique used for the evaluation of the venous system. However, due to saturation and flow effects, which may result in non-diagnostic studies, three-dimensional (3D) gadolinium enhanced gradient-recalled (GRE) imaging may be used for problem solving. Alternatively, may centers, including our institution, now forgo TOF and go directly to a 3D contrast-enhanced approach.
This is from the New York University MRI site, so NYU is a place to go on the east coast.
Dr. Dake used gadolinium enhancement, and then had the scans downloaded onto his computer, where we saw Jeff's complete venous system from top to bottom.
Both of Jeff's jugular veins stopped at the jaw/cervical neck area. One side was worse, and had lots of collateral veins sprouting out. The other side had a narrowing, and that's the side Dr. Dake is putting the stent in. He said that side will be successful in creating venous drainage for Jeff.
Time for a grass roots effort to locate and contact docs who understand this new technology and are willing to look for "venous occlusion" in MS patients. Dr. Dake believes this will be the name for what we now call "MS"- that the demyelination is a result of an a priori venous obstruction.
(Andrew...we had an hour and a half with Dr. Dake after the tests, and spent it on Jeff's particular case and Dr. Zamboni's research- I mentioned IBT and my supplement program, and Dr. Dake said that Jeff's stenosis was caused by the muscles in his neck, NOT coagulation or circulation issues. Perhaps a birth defect, perhaps from his career as a trumpet player. The only answer for Jeff is stents....but Dr. Dake also said this disease will need to be treated on a case by case basis. This is a fingerprint disease.)
Dr. Dake has spent time with Dr. Zamboni, and seen some filmed results of patients after the endovascular treatment. He said the results were "astounding"- and this was why he was so excited to perform the treatment and see how Jeff felt afterwards. As Wobbly has been hinting at, this procedure provides healing and relief.
Hope this helps. Any questions I can answer, let me know-
AC
_________________
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS 
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That said, let's not bother the good doc unless you know you have the time and resources to get out to Palo Alto. He's a really busy man, and I want to keep him fighting the good fight.
