This Is MS Multiple Sclerosis Knowledge & Support Community

Hello Dania,
You are misquoting Zamboni. CCSVI is a syndrome not the cause of MS, please read his recent paper.
You also talk about restenosis but did not provide evidence that a successful destenosis was performed. I would need to see IVUS data after the procedure to be convinced.
Until there is sufficient evidence that any ballooning technique is properly agreed I would not recommend stents nor drug eluting stents. We should be conservative in our approach and do some basic research.

MarkW

MarkW wrote:Hello Dania,
You are misquoting Zamboni. CCSVI is a syndrome not the cause of MS, please read his recent paper.
MarkW

Do you have a link to that paper?

Mark, I posted the site. So there will be no assumptions that I am doing the quoting. Not my word, sorry for the mix up. I just though some might be interested in what they are doing at the Clinic of Hearts.

Hello Dania,
If you post a site without comment you appear to support it. If you are not giving an opinion then please say so. There is a lot of mis-information being posted on CCSVI I and others try to challenge this on this site when we see it.

MarkW

MarkW wrote:Hello Dania,
You are misquoting Zamboni. CCSVI is a syndrome not the cause of MS, please read his recent paper.

It may be that CCSVI is best described as a syndrome. It may be that it will end up being causally linked with MS, with specificity and sensitivity. Because of the difficulties with determining how accurate the diagnostic imaging is, we need better research before we know which way it goes. For now it does seem safest to not talk about CCSVI as cause or cure for MS but as a syndrome. It is easier to agree upon that too, if I understand the definition of syndrome correctly.

You also talk about restenosis but did not provide evidence that a successful destenosis was performed. I would need to see IVUS data after the procedure to be convinced.

I would agree with this.

Until there is sufficient evidence that any ballooning technique is properly agreed I would not recommend stents nor drug eluting stents. We should be conservative in our approach and do some basic research.

MarkW

I would agree with this too.

What is the reason that the doctors have all been using bare stents for CCSVI, rather than drug-eluting stents? Is it because bare stents endothelize faster and a drug-eluting stent could come free? If a stent comes free in the jugulars, the direct path is to the heart, as happened to radeck.

MarkW wrote:Hello Dania,
If you post a site without comment you appear to support it. If you are not giving an opinion then please say so. There is a lot of mis-information being posted on CCSVI I and others try to challenge this on this site when we see it.

MarkW

Mark, I don't know what to say? I never thought of it that way. If I do not put a comment, I support it? I neither support this or not. I do not know enough about it. I just like to share things I find. Just like I posted REGROWING BLOOD VESSELS. People who read it can make up their own minds what they think about it.

Zamboni's paper is essential reading:

http://phleb.rsmjournals.com/cgi/reprint/25/6/269

Happy reading,

MarkW

MarkW wrote:Hello Dania,
If you post a site without comment you appear to support it. If you are not giving an opinion then please say so. There is a lot of mis-information being posted on CCSVI I and others try to challenge this on this site when we see it.

MarkW

Why don't you guys give Dania a break, already. And who are you to tell people how they should post anything? Dania simply posted and then linked an interesting article.

Besides, you and Cece are the ones spreading misinformation in this case. Read the title of the article carefully: "Drug Eluting Balloons in Liberation Treatment."

And the article says:

That’s why very recently a new therapeutic era has emerged with the advent of the Drug Delivering Balloons. This balloons have a substance capable of attaching to them the medication (Paclitaxel) but releasing it and adhering it to the contact surface during inflation inside of the artery. So after treatment and balloon deployment there is only the medication acting for a short period of time just to avoid the acute inflammation and later the artery is totally free from any foreign substance.

Very recently this same technology has been applied to large balloons to treat the arteries in the legs while reducing the restenosis rate and consequently the need for subsequent dilation treatments, with the benefit of minimal stent placement.

There are several successful trials with such balloons that were so conclusive that they justified their approval by the European regulations as well as their release into the market.


We have been using the Paclitaxel Eluting Balloons (Dior, Freeway) for more than one year with great efficacy and no complications.

It seems the whole point of this article is about a method providing some of the advantages of the drug-eluting stents, while only performing the ballooning (i.e. no stent is used).

Why is only Zamboni's paper essential reading, when no one can seem to replicate his results? And if Zamboni is misquoted, like you say, why in "Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis" did he write

Moreover, the absence of Doppler and venographic features of CCSVI in controls suggests that venous obstructions may be causative of MS rather than a coincidental finding.

?

And why are only people with MS being treated for this syndrome?

The drug eluting balloons are supposed to diminish intimal hyperplasia. We've heard reports from people of intimal hyperplasia after stents but I can't think of any who've had intimal hyperplasia after ballooning alone? It's not to say it doesn't happen but would like to hear from anyone in this situation.

Maybe tearing of the annulus would be a more successful technique if combined with drug eluting balloons, to reduce the excessive 'healing' response?

Perhaps this is a marketing technique by the Mexico clinic to set them apart. Or perhaps it is a legitimately useful technique. We have not heard any discussion of it at any of the ISNVD conference or symposiums, which makes me question it if it is not something being considered by any other CCSVI doctor.

We talked about these drug eluting balloons several months back. It is good to talk about them again. I am glad this was posted, it is of interest.

Thanks patientx. Appreciate the support.

Dr. Siskin gave me tPA on a balloon catheter when I restenosed. It's a drug that breaks up clotting and helps the vein heal after clotting and before stent placement for added adhesion.

It is very much the same as Paclitaxel is for clot disolving, which is:

Drug-Eluting Balloon Catheters

http://mediligence.com/blog/2009/03/17/ ... catheters/

CD wrote:Dr. Siskin gave me tPA on a balloon catheter when I restenosed. It's a drug that breaks up clotting and helps the vein heal after clotting and before stent placement for added adhesion.

It is very much the same as Paclitaxel is for clot disolving

I am confused by this statement. Paclitaxel binds to microtubules and stabilizes them. This induces their polymerization. Microtubules are normally dynamic. However, once stabilized by Paclitaxel, they cannot reorganize into the spindle apparatus. This would block cell division and would be a useful method for inhibiting intimal hyperplasia, excessive cellular growth, as previously indicated.


NHE

NHE wrote:

CD wrote:Dr. Siskin gave me tPA on a balloon catheter when I restenosed. It's a drug that breaks up clotting and helps the vein heal after clotting and before stent placement for added adhesion.

It is very much the same as Paclitaxel is for clot disolving

I am confused by this statement. Paclitaxel binds to microtubules and stabilizes them. This induces their polymerization. Microtubules are normally dynamic. However, once stabilized by Paclitaxel, they cannot reorganize into the spindle apparatus. This would block cell division and would be a useful method for inhibiting intimal hyperplasia, excessive cellular growth, as previously indicated.


NHE

You are correct NHE, thanks for bringing this to my attention. They are not the same drugs or have the same method of action.

That said, I had a stent previously placed in that left IJV, only days before, and it occluded. My first Venogram showed many intraluminal webs, valve abnormalities and more.

So thrombosis was assumed with US finding of no flow. Vein is occluded. Also it happened quite quickly within days. Until an additional Venography showed the persistent thrombus was caused by a small flap above the stent after the valve issue.

So indeed, neointimal hyperplasia. TPA was given, angioplasty right away, no help, so two more stents and more angioplasty, gave me antegrade flow and the procedure was decided to be terminated and anticoagulation would be used to minimize occlusion of the newly placed stents.

These two new stents overlap the first one on top and bottom.

I have flow but still a bottle-neck in the vein at the top of the stent. Perhaps pressure outside the vein is causing this, i.e. a bone. JMO

I know I need another Venogram, I had three US's. I just need to save for it since my crap ins thinks it's exploratory. I may have recourse now that local Vascular doctor, determined I had a need for one.

Sorry for the long explanation, are you still confused? I am. There is so much to learn. The more I read my reports the more confused I get.

This is all the left internal jugular, where many people seem to have trouble. Not to say the right jugular in okay now, a value leaflet on the low end needs another look. (sigh)
CD