DR. SIMKA reply about re-stenosis

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.
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Post by Cece » Tue Jul 06, 2010 8:21 am

dlb wrote:
garyak wrote:
Cece wrote: Dr. Noda was actually based in Puerto Rico, not Spain. He is retired now, it's his successors Dr. Castillo and Dr. Perez Fernandez that are carrying on the work.
Cece, is that through chelation?
This may have gotten lost. The following is something I copied from a post from Nunzio in a different thread. Think this might be the info you were looking for. Sorry about butting in, if it isn't.
Thanks, I missed this one...dlb's info is right, these docs are not using chelation at all but a CTOS surgery in which a neck muscle is partially snipped because it is believed to be compressing arterial inflow to the brain. They're treating Parkinson and MS patients this way. It's unproven and DrS has said he does not know what to make of it yet.
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition

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Re: DR. SIMKA reply about re-stenosis

Post by Cece » Sun Aug 26, 2012 7:19 am

wow, was this two years ago? I ran across the letter from Dr. Simka and thought he was right-on on many points. But there must be some things that have changed in two years. Reposting the letter
''Regarding the treatment, we opt for the most safe and the most efficient treatment, which of course is not possible, since those two parameters don't meet it every case. Balloon angioplasty has already been demonstrated to be very safe in a short time, and most likely safety in long time is also nearly perfect. But balloon angioplasty is not very efficacious. In some cases it doesn't work at all, in the others there are late restenoses. The short-term efficacy of an alternative treatment - stenting is much higher. But long-term efficacy (risk of late occlusion) is not known. Although occluded stent can be opened, but probably not in every case. And of course there are known early complications related to stents, namely the migration, that exclude some anatomic variants from stenting (at least using currently available stents). There is also possible the open repair of the vein, but risk and efficacy of such procedures are not known. Thus, all treatment modalities should be regarded as experimental, with still unknown efficacy and safety. The doctors always try to balance the risk and the efficacy factors, but the best solution is not always possible and is not always chosen (importantly, we don't have data on long term consequences of ballooning or stenting).

Now, what about impact of the treatment for CCSVI on clinical course of MS. Our data indicate that the things are far more complicated than it might be suspected.

1. CCSVI is not an equivalent for MS; most likely, MS = CCSVI + some (probably more than one) other factors

2. Consequently, treating CCSVI does not mean that MS is gone. Most of the patients experience good and bad days following surgery, importantly, during infection, stress, etc. the symptoms usually go back. But the symptoms also go back in a case of restenosis.

3. Treatment of CCSVI does not guarantee improvement. There were some patients (not much, still, they were) who experienced worsening. Most of those patients presented with severly narrowed veins that could not be sufficiently managed with ballooning or stenting, but there were also cases with "perfectly" done surgery. So, a patient can improve after surgery (a majority, especially relapsing remitting patients), but no improvement or even worsening is also possible. A reoperation can improve the symptoms in the latter two groups, but again, not in all cases.

4. Probably, surgery for CCSVI + pharmaceutical treatment will improve outcomes. Try to continue your neurological medication if it were working before surgery.

5. Many patients who suffered from transient worsening of symptoms, improved after inclined bed therapy. You can try it, even if not efficient, at least it is 100% safe

6. Postoperative Doppler examination is sometimes puzzling. In most of the patients the flow just after the suregery is still pathologic. Threfore we don't perform it after operation (we don't want to stress the patients). Even after some days there are still flow abnormalities, especially after ballooning. So, we think that patient should look at his/her symptoms first.

And, importantly, current situation when patients must travel thousands of miles to have the treatment is neither normal nor is it safe. At the moment healthcare systems seem to overregulated. It must be changed. Especially, cooperation with neurological community and big universities with access to big public money is pivotal. Surgery is not the only solution, it must be augmented by something else.

Marian Simka, MD''

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Re: DR. SIMKA reply about re-stenosis

Post by MrSuccess » Sun Aug 26, 2012 11:21 am

that's a very interesting summation of Dr.Simka's CCSVI-MS work.

As I mentioned on another thread .... stent migration in one well documented case - certainly effected the progression of CCSVI treatment.

Professor Zamboni openly stated his opposition to stent placement . In spite of his cautious warning of possible problems ..... stents were inserted in pwMS by Dr.Simka.

To my dismay ..... Dr.Simka contined to stent his CCSVI patients in spite of the great concern of stent migration. He seems to have ignored Dr.Zamboni's stent caution ....

Dr.Simka has probably the most experince of all CCSVI health professionals , when it comes to stenting.

I look forward to reading his updated CCSVI - stent research.

Many stent recipients report good news.


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