Of course we don't know what causes restenosis yet. But restenosis is a common problems in coronary arterial angioplasty, and I suspect that it is entirely a different phenomenon than "restenosis" in CCSVI. In coronary disease, the arteries a cloged up and angioplasty baloons squeezes them open, and inrestenoses probably results when they re-clog up. In CCSVI the stenosis seem to be a result of the congenital shape of the veins, and the angioplasty balloons squeeze them into an open shape. Restenosis may be the veins rebounding to their prevous shape, or a healing shut after trauma of being stretched. Probably not the same thing, and the use of stents would be different.
I suspect one reson definitley is elastic recoil, but we don't know yet. I slo suspect that the trauma that the vessel intima suffers when the balloon stretches it way beond its revious shape may result in "healing" or scaring that closes the vessel. In this way it may be similar to what they are seeing in arterial restenosis, and may even result in a person getting worse than they were before treatment. It is very important to start to get on top of this phenomena, especially if people start to get worse after tretment than they were before.Cece wrote:I vote for "elastic recoil."
It's a term drsclafani has used, I think it means exactly what you're describing.
I agree too that this is a very different sort of stenosis that arterial plaque build-up.
Maybe a series of balloons of gradually increasing size will be better. Maybe as small a balloon as possible to restore adequate flow to minimize trauma (Dr. Sclafani thinks probablly the biggest balloon possible without rupturing the vessel ... who knows yet?)
Agree about the intimal hyperplasia as well.
We've seen very few reports so far of people who are worse after the procedure than before. That gives me optimism. But it's still self-selected self-reporting and anecdotal etc until the docs get the studies rolling.
'Rebound' would make me think things have turned for the better and in restenosis they have turned for the worse.
Yeah, I guess ou're right. It is a cescriptive term, and as long as we don't know why, we might as well just use that generic descriptive. Plus the IR's know what they are talking about then.Lyon wrote:It seems that the definition is stenosis regardless of the reason for the narrowing or the type of vessel so it seems that subsequent narrowings would be restenosis, regardless of the reasons for the narrowing or type of vessel.definition wrote:ste·no·sis
–noun Pathology .
a narrowing or stricture of a passage or vessel.