daytrader wrote:My Doc agreed to do a bypass if the vein above the clot is good. We can't tell on the ultrasound cuz there is no flow there. I sure hope it is good. This time if I clot up we will be back in there A.S.A.P.. I will post once I know. I am waiting on the MRV date as this all just happened yesterday. I know there are many in my position and ready to have hope again.
we have not summarized the causes of occlusions
I can think of a variety of scenarios for clotting
1. hypercoagulability,include hughes syndrome, protein deficiencies
2. inadequate anticoagulation after the procedure
3.excessive dilatation leading to disruption of the wall and thrombosis acutely
4. treatment of a hypoplasia.
5. More downstreat stenoses, such as of the inominate vein
6. tandem stenoses with incomplete treatment of the upper vein. I had a windsock above a valvular stenosis. It would not open despite nearly 40 Atm of pressure. Unfortunately, the lower valvular stenosis, simple as it was, thrombosed, or perhaps the windsock thrombosed.
7. dural sinus stenosis or occlusion of the junction of the IJV and the dural sinus. Might be chiari, might be a malalignment syndrome at the skull base, might be hypoplasia of the foramen where the vein comes out of the skull
So it is good that you are getting an MRV. make sure you get one of the neck, but also one of the head to look for intracranial outflow problems.
also make sure you are tested for all the hypercoagulable states. Also make sure you are not on BC pills or smoke or take anything that will make you hypercoagulable.
Also make sure that there are no downstream obstructions that will impede flow of the IJV graft.
I wish you luck. I am pessimistic about these surgeries.