This Is MS Multiple Sclerosis Knowledge & Support Community

Posted: **Fri Jan 20, 2012 6:42 pm**

4th ARAB RADIOLOGY CONGRESS 2011

LEBANESE SOCIETY OF RADIOLOGY

28th - 30th April 2011

CCSVI IN MS. DIAGNOSIS AND MANAGEMENT

Tommaso Lupattelli (Italy)

Introduction: Chronic cerebrospinal venous insufficiency (CCSVI) is a recently discovered syndrome mainly due to stenoses of internai jugular ( IJV) and/ or azygos (AZ) veins. The aim of the present study is to retrospectively evaluate the feasibility and safety of endovascular treatment for CCSVI in a cohort of patients with multiple sclerosis (MS).

Study was of 206 MS patients.

One patient underwent selective venography alone due to no evidence of significant stenosis in the IJVs and AZ. In four additional patients the decision to carry out the interventional procedure was solely taken after selective venography which disclosed at least one significant stenosis in the IJV or AZ territory despite a negative Colour Doppler Ultrasound for CCSVI.

Only one patient failed to have any CCSVI stenoses. Four had a negative ultrasound but had stenoses upon venogrpahy.

Major complications included 1 (0,5%) severe bleeding in the groin requiring open surgery, 1 (0,5%) surgical opening of common femoral vein to remove balloon fragments and 1 (0.5%) left IJV thrombosis 28 days after discharge. Minor complications included, 3 (1,5%) procedure-related technical issues, 3 (1,5%) transient atrial fibrillation requiring a further 12 hour hospital stay, 10 (5%) slight bleeding or haematomas in the groin ( 3 requiring further hospital care the day after intervention and 3 prolonged hospital stay) two right neck haematoma (1%) both occurring the day following the procedure and one (0,5%) haemo- tympanum on the 25th day after discharge.

Discussion & Conclusion: Endovascular treatment for CCSVI appeared feasible and safe. However, a proper learning curve can dramatically lower the rate of complications. In our experience, all major complications occurred in the first 50 cases performed.

Better to be patient #51 than to be #1....

Posted: **Fri Jan 20, 2012 11:06 pm**

... the second mouse always get's the cheese ......

MrSuccess

Posted: **Sat Jan 21, 2012 5:01 am**

My first procedure in Athens, Greece (June 2010) was before the first fifty the Vascular Surgeon had operated on. No regrets at all. I was under treated according to DrS who performed my second de-stenosis. If you are going to a less experienced CCSVI practioner then I suggest you find someone who is cautious in their approach. For me, using IVUS is essential to find all issues and correctly size the balloon.

MarkW

Posted: **Sat Jan 21, 2012 6:38 am**

I agree, I think my damage was done by an IR who had not treated many and was too aggressive:(

Posted: **Sat Jan 21, 2012 7:40 am**

If you are going to a less experienced CCSVI practioner then I suggest you find someone who is cautious in their approach.

I agree with this! But in order to find one who is cautious, you have to know enough about the procedure to identify the difference between cautious and aggressive.

Posted: **Sat Jan 21, 2012 8:50 am**

MarkW wrote: For me, using IVUS is essential to find all issues and correctly size the balloon.

I hope people will use this forum to find a practitioner who uses a cautious approach. I am here to help pwMS to get the right therapy - Vitamin D3 and gold standard tools are my recommendations.
Cece you supply a vast amount of info for pwMS. I hope they take notice rather than reading adverts from clinics.
MarkW

Posted: **Sat Jan 21, 2012 10:12 am**

Mark, the link to on your post is broken

This Is MS Multiple Sclerosis Knowledge & Support Community

a reason not to be among an IR's first fifty CCSVI patients

a reason not to be among an IR's first fifty CCSVI patients

Re: a reason not to be among an IR's first fifty CCSVI patie

Athens, Greece (June 2010) before number fifty

Re: a reason not to be among an IR's first fifty CCSVI patie

Re: a reason not to be among an IR's first fifty CCSVI patie

Cautious approach

Re: a reason not to be among an IR's first fifty CCSVI patie