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drsclafani wrote: SLOWFLOW If there is resistance to outflow from the brain, this may lead to reduced inflow to the brain. That may lead to reduced oxygen delivery to the brain and cellular function may be compromised without oxygen. and it may ultimately be the cause of deminished brain size. Perhaps it is improvement in blood flow after angioplasty that explains the very rapid improvements in neurofunction that some patients experience. Clarity, return of sensation, etc sometimes are seen before leaving the hospital. Of course it could be placebo, but it could also be improved brain function because of improved brain flow.
QUESTION2
namely the debate of stenting and angioplasty. Firstly, we do not have ideally designed stents, there are concerns about migration because of the dynamic and considerable ability of these veins to dilate, and we do not have clarity of their long term outcome. It is therefore reasonable to attempt angioplasty first as it is safe and relatively simple. Repeating it is not a problem as the risk of the procedure is low.

Therefore I am inclined to treat by angioplasty alone first. See how things go. if symptoms recur, if stenosis recurs, then comes the decision making process that must be a plan devised by patient and doctor. If a patient's symptoms have imroved after angioplasty, cog fog, numbness, etc, then the decision is really a quality of life issue.

drsclafani wrote: The spinal cord has an interesting venous drainage. There are small veins that exit the spinal cord and enter venous plexuses that surround the spine and vertebrae. (A venous plexus is a tangle of very small venous channels and lakes. )These plexuses connect up and down the spine. Some then drain out into larger more defined veins. These veins can drain upward into the brain and then back down the venous sinues to the jugular vein. There are also veins that connect the cervical plexuses to the upper jugular vein itself. The cervical venous plexus also drains into the vertebral veins and they connect to the subclavian or innominate veins. lower down in the thoracic spine these plexuses drain into veins that connect to intercostal veins and hemiazygous and azygous veins. Lower down still there are veins that connect the vertebral veinous plexuses to lumbar veins, ascending lumbar veins, and the inferior vena cava and lots of other veins.

vein1 wrote:The Australasian College of Phlebology is taking CCSVI seriously and is the process of organising clinics throughout Australia and New Zealand to assist patients with MS that may have CCSVI. However, due to resistance from other areas of the medical profession, it is a slow and difficult task.

Phlebologists are specialist vein doctors. Professor Zamboni, as well as being a vascular surgeon, is also a phlebologist, and this is the practice through which his work is best known. Professor Zamboni has accepted our invitation to attend our Annual Scientific Meeting in Melbourne March 2011.

Our role is to assess then advise how CCSVI is best managed. As a multi-disciplinary body, we are fortunate to have interventional radiologists as part of our membership, and these, along with interested vascular surgeons are helping to provide the early, minimally invasive, therapeutic interventions.

Melbourne patients are fortunate to have Professor Thomson already actively engaged in the treatment of CCSVI. His IR colleague, Professor Bester is also enthusiastic to provide a similar service in Sydney.

I am in the process of setting up the first dedicated CCSVI Clinic in Sydney, and I hope this to be operating by mid April. In the meantime, I am pleased to see and assess MS patients in my office in Newcastle.

Dr Paul Thibault

Opera wrote:Just wondering how persons who have already undergone the procedure are faring. Trust all is OK.