drsclafani wrote:Well, now that the symposium is completed, i have had some time to think about interesting and informative cases.
Speaking of that symposium, how was your IVUS talk received?
there were someone who stated that there really wasnt any use for ivus, that it was an academic tool. However that person does not regularly use it, so i do not know what that opinion was based upon. Dr Zivadinov, whose group does use it, suggested that IVUS was probably the Gold Standard. Another opinion.
You all know my opinion. The Gold Standard includes venography and IVUS.
Did any of your colleagues bring up anything that made you think differently about any aspect of CCSVI?
Is Dr. Beggs really onto something? I've yet to work through his ideas, but I'm guessing it's worth the effort.
You are too much cece, you put the question and the answer back to back. I like the way Dr Beggs explains things. he works on mathematic models using data published by others. He is so brilliant in his clarity as he explains the logic of the physical world.
I have been digesting his ideas since bologna
Dr. Siskin has weighed in here at TIMS on what he said at the conference about him seeing less positive outcomes and more risk of thrombosis if a patient has multiple procedures. Did the discussion at the doctors' days influence your thinking from what you said at the patient day, that as far as you knew so far, it was unlimited?
If i recall, i meant the number of procedures that could be done on a patient could be unlimited, meaning that I didnt have any way to know what the limits are going to be. We are not treating something we have long experience with. . Angioplasty of stenotic valves in veins that are often dilated above and below the stenosis iw quite different from anything else we have done. We still have little detail about each practitioner's techniques so we cannot tell which maneuvers injure veins.
I have had the opportunity to re-treat a few patients who had been treated at sites in Asia, North America and Europe more than one year ago. The majority of the problems were either missed or underestimate obstructions or they were related to stents. Many other vessels were treated, yet on a venogram at the one year mark, it was often difficult to detect the sites of angioplasty. So where is the evidence that repeat procedures result in worse damage to these veins?
I have also seen patients have less improvements from a second procedure. We have to figure that one out.
The more I know, the more I realize how much there is learn.