Dr. Sclafani's Thread Index (Pages 1-320)

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.
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Dr. Sclafani's Thread Index (Pages 1-320)

Post by AlmostClever » Thu Apr 29, 2010 10:15 am

Moderator's Note: Thanks to AlmostClever for putting together this index of Dr. Sclafani's thread, "DrSclafani Answers Some Questions." I have created links to each of the pages and made it sticky. I hope that AlmostClever will continue to update the index. Additions to the index will be updated here as they are made available.

Page Question Topic

Page 1
Colleague acceptance
Valve probs
New problem in jugular
Stenosis come and go

Page 2
Effects of low flow
Collateral veins
Contact info

Page 3
Blood flow

Page 4
Jugular access
Low blood pressure/mean transit time
Angioplasty debris

Page 5
Angioplasty nerve damage
Venoplasty through heart
Stenosis location
Valve problems

Page 6
Intravascular ultrasound
Collapsing veins and treatment
Ballooning skeptics
Ballooning solve valve probs

Page 7
Dr. Love
Alternative solutions
Flow and reflux
Lumbar veins
Spinal cord drainage
Angio and stents

Page 8
New covered stent
New stent development

Page 9
Vein repair
Blood circulation problem
Angiogram CCSVI diagnosis
Pressure gradients

Page 10
Pocket in IJV
Procedure curiosity

Page 11
Blood flow vs lesion location
Veins in CCSVI

Page 12
Addressing stenosis prior to procedure
Restenosis cause/prevention

Page 13
Too much brain drain
Restenosis prevention / Vitamin K
Doppler question
Cutting balloon

Page 14

Page 15
Vein narrowing quantification
Vein wall weakening
Doctor experience
Vein scenario question
Venogram learning curve
Sleeping position
Sclafani peers

Page 16
Childhood CCSVI detection

Page 17
Childhood heart operation
Pressure gradients
Ballooning veins
Procedure follow-up
Treating early MS'ers / CCSVI
Problems found in all patients
Seizures and angio

Page 18
Vertebrobasilar insufficiency
Collaterals and stenosis
Situation impression
Distending vein / collaterals

Page 19
Cold hands/feet
Low blood pressure
Surgical repair of stenosis

Page 20
Presence/absence of valves in jugulars
Radiation and CCSVI
Bad joke about Hillary Swank (diet)

Page 21
Upper narrowing significance
Sclefani's dad/childhood
Blood thinners
Vascular malformations
Ultrasound question

Page 22
Flying and anticoagulation
CT-V Scan vs MRV

Page 23
Pre-departure advice
CT-V question
Vein elasticity
Flying and anticoagulation
Real stenosis
Vein scar tissue

Page 24
Causes of narrowing
Radiology 101

Page 25
MRV question
Femoral nerve damage during angio
High stenosis

Page 26
Sclefani procedural improvements

Page 27
Leiden Factor V and stents
Legal fear / procedure stalls

Page 28
Elastic recoil

Page 29

Page 30
MS treatment resistance
Research and procedure
Research and procedure
Research and procedure

Page 31
Elective procedure?
Iron theory

Page 32
Neuro participation w/ Sclefani
Treatment complication comparison

Page 33
Positional flow
Neuro recruitment

Page 34

Page 35

Page 36
Only 7 years of proof…
Insurance economics

Page 37
Procedure risk
Iron theory

Page 38

Page 39
Iron question
Iron deposition
Kuwait comments
Old dogs…
Sauna post-treatmenr
Umbilical cord question
Diagnosis/procedure codes

Page 40
A new inspiration/gratification

Page 41
Dr. Sacks
Procedure stats
Congenital/non-congenital causes

Page 42
Only 1 jugular vein
Hippocrates Oath (modern)

Page 43
Fetal demise
Crappy vein syndrome and MS
Invisible "missing" jugulars
Vein dye
German peers
Red feet

Page 44
IRB process
How to help Dr. S
Pregnancy stuff
Physical therapy

Page 45
Student interest?

Page 46
Vein treatment
Stent issue
Pregnancy and blood volume
Chiro neck manipulation

Page 47
High EDSS question
Azygous MRI imaging
Carotid artery rubbing, sleepiness
Legs after treatment
Contact info

Page 48
Fatigue vs Sleepiness
Zamboni pathological reflux definition/paper
"Confounding variables"
Multiple angio's
Duplicity and drainage of critical areas
MS and multiple diseases/conditions

Page 49
The power of suggestion…
Catheter Venography with IVUS

Page 50
Stents and Chiros
Dyes and Reactions

Page 51
Kuwait comments / Letter to Dr. Sinan
Response from Dr. Sinan
Upcoming trial description
Get on a list!

Page 52
Echo-Doppler discussion
Pressure and reflux
Normal, Anomaly, abnormality
Seek testing quality
Screening vs definitive testing
IJV, collagen, connective tissue
Throbbing neck veins
CCSVI and Tinnitus
Relax after stents

Page 53
Vertebral vein reflux/getting 2nd opinons
More Kuwait…
Getting IRB approval
Transcranial magnetic stimulation

Page 54

Page 55
"Doctor-speak"/word play...
Local NYC IR interest
Nunzio showing off

Page 56
Zivadinov's Iron Deposition
Blood Thinners and Ballooning
Ballon Angioplasty Trial Obstacles
Non-MS'er testing
Aspirin and Venogram
Ultrasound and Intracranial Veins
Dr. S plans to treat!
Some veins too small to balloon, verts and collaterals...

Page 57

Page 58
Must test invasively
Stents more or less permanent
Can venous issues develop from trauma?
Positive/Negative Reflux
Hospital practices

Page 59
IRB approval = hospital go ahead
CCSVI is hospital issue, not US DHHS

Page 60
Restenosis as a control

Page 61
Robert cont'd
Trial details
Visible external malformations
Questions for your surgeon
Sleeping position question
CCSVI Patient Registry?

Page 62
Which docs have the best experience?

Page 63
Neurovasomotor problems in extremeties
Continue immunosuppressing drugs just prior to procedure?
To stent or not to stent?

Page 64
Doesn't IRB know Liberation is safe?
Beyond azygous and jugular?
Why does CCSVI warrant treatment? Proving it…
Spinal cord MS
Restenosis? Go right back to venogram…

Page 65
Dramatic improvements?
Hotels near Dr. S

Page 66
Guessing/Waiting is the hardest part!
Nitro-Liberation Warning
Improvements by MS type
In-stent Restenosis
Artery vs Vein ballooning/stenting
Placebo doubts
Jugular stent design
Stenosis size/location treatment

Page 67
Azygous learning curve
CT Scans
Bifurcation narrowing
The Elusive Azygous

Page 68
Vein replacement
CCSVI criteria
Is lesion & stenosis location related?
CCSVI Tests and Descriptions
Venograms missing abnormalities
No Jugs required!?!?

Page 69

Page 70
Variation of CCSVI abnormalities
Scan entire body?

Page 71
Missing jug cases
Dr. S.'s IRB draft
Advice for Newbie IR's

Page 72
Teamwork planning
Vein grafting
Trials and Trickulations

Page 73
Longterm prognosis
Catherization thru inguinal (and heart) vs brachial vein
"Acute congestive plethora of the head"
Neuro's evaluations needed
Trial compromise

Page 74
CCSVI Literature for docs scarce
Stents removed?!?!?!
Neuro interviewing before & after Lib Pro
Ethical trial? How?
EDSS 8.5++

Page 75
It's more of a safety study…
Brain trauma and angio safe?
"No treatment" is the Control
Venography detection rates higher
more Trial talk…

Page 76
Pesky Placebo & Unquantifiables
A Rewarding Journey Has Begun

Page 77
Trials - Safety First!

Page 78

Page 79

Page 80
Doc S. - Back after these messages…

Page 81
Patient and Statistic Significance
"ndwannabe" case

Page 82
Receptive colleagues…
Insurance money, Training and Seminars
Patients and Controls
What are we treating?
Scanning is moot - Liberate!
Buffalo Study advice
Membraneous issues seen?
Predicting restenosis

Page 83

Page 84
MSQLI (MS Quality of Life Inventory)
"tzootzi"'s wife
Total MRV (MR arteriogram)

Page 85
Starting with the big veins…
Measuring Cerebral Oxygenation
MS - not one size fits all…
Why study the neck only?
Study response of all symptoms…
Exclude MS family members as controls

Page 86
Why scrutinize studies?

Page 87
Ultrasound protocol question
Specific studies later on…
MRV and Baclofen Pump
Focus on treatment, outcome, learning

Page 88
Diminishing control group?
Online patient assessment
"astro" case question

Page 89
Dr S - (almost) Super-Doc!
Comments on "costumenastional" images
Venogram/Angio Contraindications
Clotting disorder and Venogram/Angio
Comments on Dr. Freedman interview
ED (not what you think!)
Collaterals indicate outflow obstruction

Page 90
Pacemaker and MRV?
How to get on Dr. S' List
Don't give advice to those who don't ask for it…
Diabetes, MRV and contrast
PPMS - too early to know…
Venogram vs MRA
CT Scan - pros and cons

Page 91
Dr. Dake trial question
Following/maintaining patient data
Consistency of follow-up evaluations

Page 92

Page 93

Page 94
"Informed Consent"
Angioplasty trials
Global data collection / Squeekycat questionnaire
Why do we need controls if it seems to work?
Science must prove it
Medical community needs convincing evidence
Experience, experience
MRV not good enogh for Azy, use contrast in MRV
When to start exercising again?
1 vs 100 (Treatment vs Study)

Page 95
Venogram test of choice!
Types of trials needed
Safety first
Studies and Doctor Skill Level
Vein rupture
"vivavie" - difficult Azy vein
IVUS benefits
"Informed Consent" requires more research
Stent size - pros/cons

Page 96
Dr. S. holding back?

Page 97
Volunteers needed for trial consent feedback…

Page 98
no test 100% accurate

Page 99
No improvement in PPMS but hopefully no progression either
Extensive reflux with no blockage?
Why not perform unproven techniques if they seem to work?
Look at CCSVI patients as cohort instead of MS'ers?
Stent migration possibilities
Catheter Venograpy and Irregular Heartbeat
Vein Valves
Doctors treat patients - not groups
Procedure not new, the group application is
Venogram - too much, too little dye

Page 100
Overstretching veins/ drugs to raise, lower BP
CTOS? What is…
Switching docs after procedure
One vein problem leads to another…
Dr. Zamboni advises staying on meds after procedure
Zamboni Letter
Does remission mean the stenosis went away?

Page 101
Why isn't vein dilated when there is elevation in pressure?
Mostly valve problems?

Page 102
Radiation / 3T MRV vs 1.5T MRV / Study length
Irregular heartbeats due to flow probs?
Hand and foot circulation improved by Jugular flow?

Page 103
Any proven association between CCSVI and other venous valve problems?

Page 104

Page 105
Damn A/C! That MRV sucks!
Flap, Web, Septum in veins
More on "Cutting" Balloons…
Vein healing process / Anticoagulation strategy

Page 106
MR Scanners and Metal
MS is the Real Enemy
Balloon and Stent size question
Duplication of Jugular Vein
Doppler, ECU, Mrvenogrm, Cather Venography - What can be seen?
When will Dr. S resume procedures?
Treating narrowed veins based on what?

Page 107

Page 108
Medicine (& Emoticon Use) is an art! :wink:

Page 109
Donate blood while on anticoagulants?
Narrowed jugular, CCSVI!
What medical records/reports should I bring?
Coumadin, Heparin / To use anti-coag's or not
Doctors should document MS symptoms and defects found

Page 110

Draining the Brain
"HappyPoet" test report questions
Cutting Balloon and Dural Sinus
Jugular Foramen
Fix blockage, increase vein diameter and flow?
"Patience, my patients!"
Acne and CCSVI?

Page 111

More CTOS…
Vertigo drug increase bloodflow?
Doing CCSVI (research) right…

Page 112

Stent or No Stent…
Things heard in a neuro’s office…
Stent Reluctance
Stent IRB in the future

Page 113

Hurry up and – wait!
Heart Flutters / Cardiac Rhythm

Page 114

Why do the procedure if benefits are unclear? / University providers needed
Can angio cause new stenosis?
Patients know best…
"Cheerleader" husband case

Page 115

Page 116

Page 117
Doc’s away…

Page 118
TIMS’ers making a difference!

Page 119

Page 120

Page 121
Doc coming home…

Page 122
Cutting Balloons
More on Cutting Balloons…
Iron Theory…
Other imaging forms?
Color Doppler Ultrasound
Dr. S job description…

Page 123
Website Plans
FDA role/involvement
IRB Protocols
Europe first…
Biggest thread?

Page 124
Becoming "Standard of Care"…
Need studies and data…
Always vein narrowing? MRV note
Catheter: Enter left side? Why?
Relapse after Liberation
MRV inaccurate/misleading
Venogram accuracy
Low/High Lesions, "Phasic"
When to use stents & Azygous ballooning

Page 125
Diagnostic Only studies: wastle of money
Cutting Balloon and Bleeding?
Note on procedure cost
Dr. S Future Plans

Page 126

Page 127
Can illness bring back symptoms?
Procedure repetition? / Does MS type predict degree of improvement?
Can Clavicle affect Azygous vein?

Page 128
Ultrasound procedure description

Page 129
Call me crazy…
Ultrasound questions
Flair triggers / illness
Dr. S. Safety Study Description
RPMS classification

Page 130

Page 131
Lumbar veins
Post-procedure outcomes/Lumbar vein
Post-procedure outcome question
Inferior vena cava / Gonadal vein
CCSVI: Worse over time or damage accumulation?
IRB update
State of Imaging Study idea

Page 132
Papers brought up by IRB

Page 133
Hold onto your CD’s!

Page 134

Page 135
Break time…

Page 136

IRB Proposal Denied

Page 137

Page 138

Page 139

Page 140

Page 141

Page 142

What to do? What to do?

Page 143

Page 144

Page 145

Page 146

May-Thurner Syndrome comment

Page 147

Check all Veins?
Resubmit proposal?
Difficulty with "Sham" Operation / Empathy
May-Thurner Disease comment
Don’t send money! (Will work for…BOOZE!)
Experience of doctors for randomized trial
Study while on DMD’s answers what?

(Glad you’re back, Doc! :D :D :D )

Page 148
IRB Proposal Points…
Belmont Commission Report: Protection of Human Research Subjects
BNAC Study and DMD’s

Page 149
50/50 overall improvement

Page 150
Vein measurement / comparison
Legitimate reasons to treat CCSVI itself?

Page 151

Page 152
Comment on Italy and CCSVI
Problem with IRB proposal…

Page 153
Faulty valve, blood flow, pregnancy questions
IRB’s, Treatment clinics…
Catheter is best…
Liberation for "Fuzzy mentation"?
May Thurner, CCSVI
Doing the Procedure…

Page 154

Page 155
Dural Sinus, IJV Stenosis
Case Reports and Medical Journals…
Testing for CCSVI without MS diagnosis?
Why look at left Iliac and Renal veins?
Comment on news article,,,
Thyroid gland and CCSVI
Vertebral vein problems, Better esponse to second angioplasty?

Page 156
Thyroid? Grave’s Disease?
Cerebral Venous Thrombosis CVT (and MS)
Can I use your images for CCSVI Imaging Atlas?

Page 157

Page 158
CCSVI opposition and progress…
How common is venous angioplasty?
Causes of headaches from angioplasty?
Azygous abnormalities

Page 159
What good is this thread? Looking back…

Page 160

Page 161
Can azygous vein suffer if jugulars ae normal?
CCSVI Atlas / where to send images
Canadian doctor contact?
Thyroid (more…)
Thyroid (more…)
Make Money or Help Mankind? Both?
Trauma that can injure veins
Is catheter venography warranted if jugulars appear normal?
MS’er letters to no avail…
Non-MS blockage complications / Budd Chiari Syndrome
Dr. Hubbard comment

Page 162
Procedure now or later? Pros and cons…
"Algis" and Taiwan
Any pre-CCSVI discussions?
It’s a personal decision…
Improvements gone after a week – what now?

Page 163
Some insurance is paying for CCSVI
Aaron Miller
Procedure and stent complications?
Catheter Venogram / MR Venogram / Ultrasound
Veins and chemical trauma
High jugular stenosis repair?

Page 164
"Nunzio" clarifies Mitoxantrone treatment
"Apologize only for ignorance you choose not to correct" – S. Sclafani, 7/2010
Post-procedure anticoagulation
Anticoaglation (Love Thy Doctor!)

Page 165
Will ballooning keep bad valve open after balloon removed?
SUNY symposium (Sclafani, Siskin, Sinan, Haacke, Salvi) July 26
Inverted Valves
What to stop taking prior to procedure?
Abnormal valves
High pressure balloon
More on SUNY Symposium

Page 166

Page 167

Page 168

Page 169
Online CCSVI Atlas?
"LadyGazelle" Doppler image
Dr. Kostecki
IR – To go where no doctor has gone before

Page 170
Contrast and Iodine
Transverse Sinus

Page 171
Venogram one day, procedure the next?
Lumbar and SPMS, PPMS
"Mooshell" small external jug?
Lost defib. Wire causing CCSVI/MS?
Catheter Venography / IVUS
How commonly is IVUS used?
The Headhunter
Doc. S – no sedation, no analgesia
More on IVUS…

Page 172
IVUS benefit outweigh the cost?
Can one treat an occluded inominate vein?

Page 173
Thrombosis question
Is IVUS catheter reusable?
Concerns about early CCSVI treatment
Dural sinus occlusions

Page 174
62-90% incidence
If venoplasty isn’t an option, is surgery?
Second opinion – get one!
Interpreting "Johnnybaby’s" report

Page 175
Germany CCSVI
Find an IR who does complete Liberation
+/- IJV CSA delta

Page 176
Risk of stroke during Liberation?
Can reflux go away gradually after Liberation?

Page 177
(Holly) Dr S. Waiting List info…
Vein volume formula
Is this "Sticky Blood"?
Dr. Sclafani ASKS some questions…
Jugular vein size and flow rate
Symposium on CCSVI info…

Page 178
DOPPLER DIAGNOSTIC OF CCSVI test prescription/Zamboni criteria

Page 179
Catch re-stenosis early – consider 1 month check-up
Symposium talk…
Spinal cord and CCSVI question

Page 180

Page 181
Insurance and screening

Page 182
How to do follow-up / Azygous question
Fact checking…
"LadyGazelle" case

Page 183
Artery pushing jugular?

Page 184

Page 185

Page 186
Props for Dr. Salvi / Setting up the ISNVD

Page 187
CCSVI vs Cancer
Local follow-up
Cancers around the Azygous paper

Page 188
Letter to Dr. Zamboni

Page 189
Veins inside the brain?
Venogram and Dural Sinuses
Risk vs Benefit, Multiple Procedures
Anals of Neurology Rebuttal
West Coast Symposium?

Page 190
Talking to my Doc / Commonly treated veins (historically)
Dural Sinus, Sigmoid Sinus
Is Diabetes a contraindication to Liberation Procedure?
Vein compression

Page 191
IR’s coming up to speed
IVUS expensive
Treat in multiple visits?
Larger diameter ballooning of Azygous
Symposium Follow-Up questions
"nunzio" MRV comment

Page 192
Multiple visits = Waste, more risk
Dilating Carotid impressions / Vagus nerve / Bradycardia
Lmbar veins / Doctor comfort level / Vein tear? / Trends?
Blood flow and nerve function restoration

Page 193
Compression of Jugular by Carotid Bulb or Strap Muscle
(Symposium video links by "girlgeek33")

Page 194
Low stenosis causes appearance of high stenosis/Dominant flow/Dural sinus thrombosis
More on 2-treatment strategy…
Ascending Lumbar Vein and small veins
Temporary feeling of "Normal"?
PPMS – especially need Azygos and Ascending Lumbar Venography!

Page 195

Page 196
Over-stretching veins?
Ballooning info….
TEE (Transesophageal Echo)
Air in veins?

Page 197

Page 198

Page 199

Page 200

Page 201
Jugular ligation

Page 202

Page 203
"Nunzio" MRV comments - Vertebral veins
Comments on German and Swedish studies
Stenting questions
Flared stent?
Balloon Pressure
Normal reflux?
Balloon questions

Page 204
Cutting balloon
German and Swedish study

Page 205
Kissing Balloons
Realistic Expectations
Stent question

Page 206
Relapse question

Page 207
More relapse theory…
Left side entry / May Thurner’s
More May Thurner
Nonthrombotic Ilizc Vein Lesion (NIVL)
Renal vein / May Thurner

Page 208
CCSVI ala Zamboni
Do Sinan and Petrov use IVUS?
Talking & exposed jugulars
The Pill, steroids
Problem with jugs and verts
Repeated dilation

Page 209

Page 210

Page 211

Iliac, Renal, Lumbar drainage
Stress, CCSVI, MS
Thrombosis, Stents

Page 212

Should kill 2 birds with 1 stone!
Veins and brain drainage
Endothelial cells and permeability
Why aren’t red blood cells found in spinal fluid?
Accidents and CCSVI
5-40% has not met criteria for CCSVI
My CCSVI 1-year anniversary!

Page 213

Page 214

Developing a standard protocol
Stress, CCSVI, neurological symptoms
Total blockage of azygous
Stenosis, reflux

Page 215

Zamboni protocol question
May-Thurner treatment
Azygous restenosis incidence rate
Venous insufficiency
Are pulse steroids bad before angioplasty?

Page 216

Post-Zamboni IR activity
May-Thurner and symptoms

Page 217

Can narrow/blocked veins cause high blood pressre?
No improvement. Now what?
Zego machine?
Jugular veins, restenosis
Numb leg after procedure
MRV after chiro adjustment?

Page 218

Page 219
Balloons – avoiding breakage
How high up? / Vertebral veins / High venoplasty / Balloon low may fix high stenosis
China and MS

Page 220
Can hypertension cause narrowed veins?
Valves, stenosis, scar tissue, artherosclerosis
Neck mass and CCSVI, scan interpretations questionable

Page 221
Bruising and venogram / Hypercoagulability
The need for a CCSVI treatment registry
Aspirin and Hypercoagulability
PPMS prognosis
Neck massage / Angle for Jugular vs Vertebral vein flow?
Incision technique and scarring

Page 222
Incision technique and scarring
Hypoplastic Jugular

Page 223
Scarring underneath skin from incision
What Sonographers and Angiographers should look at:

Page 224

Page 225
What happens to collateral veins after Liberation?

Page 226

Page 227
Balloon question
Certification of CCSVI Treatment Centers
Azygos Vein question
A May Thurner? Image
Notes from Belfast Discussion/Debate

Page 228
Disease duration and burden predict outcome?
Missing Azygos

Page 229

Page 230

Page 231
Ultrasound vs MRV to screen
Be part of a study – not necessarily a randomized trial
Vertebral veins
Comment on randomized trials
Vertebral veins
Blocked Jugular AND Vertebral veins
Separating non-MS symptoms from MS

Page 232
Vertebral, Subclavian, Azygous stuff
Comments on treatment
Would you stent the first time?
CCSVI screening
Stents, Balloons
Vertebral vein valves

Page 233
The need to improve Doppler
Progressive dilation, Cutting balloons
Skewing results, "Metal-mania"

Page 234
2 obstructions = CCSVI
Lumbar Veins
Dissolving stents
Veins – Collapsed vs Stenotic vs Narrowed
I’m here to stay!!!
We do not know whether or not CCSVI causes MS
Symptom correlation to specific vein issues?
CCSVI theory for upper spinal cord lesions

Page 235
CCSVI theory for upper spinal cord lesions
Vein wall injury
Reasons for worsening, then recovering symptoms
Felux types - Is intervention warranted in the absence of reflux?
Does balloon dilation stop blood flow?
Azygous challenges
Ballooning discomfort, flow stoppage

Page 236
Iliac vein / Coumadin and clots / Blood clots after angio

Page 237
Azygous and webs
Radiation and stenosis? Angio can be done how many times?
Vein elasticity
Scarring, Restenosis, "Rotor-rooting"
Valves and catheter advancement

Page 238
Iliac vein, swelling
Treating one vein, checking the other for improvement?
Stenosis location and disability / Jugular vein has been dx’ed as a Vertegral!
Detecting restenosis quickly with Ultrasound

Page 239
Safety first – the randomized trials…
Stent concerns / N-Acetyl Cysteine
N-Acetyl Cysteine
Neck brace? / Stent issues

Page 240
Trying to set up shop…
Heated balloons?

Page 241
Vit K vegetables. Clotting, Coumadin (Warfarin) dose, diet
Proving CCSVI will take time!
Contrast media risk and Saline
Traveling / Hypoxia and clotting
Finding Nemos (Neuros)
Drinking fluids and Contrast Nephropathy
Laser for clots?

Page 242

Page 243
Sore jugulars, follow-up with Duplex US B-Mode
Stopping Atrophy?
Reflux – 2 kinds
Beirut study
Thyroid cysts and collaterals
"Comparative intent to treat study"
Dilated blood vessels and blood pressure
CCSVI likely congenital

Page 244
Blood thinner – Antiplatelet and Anticoaglation therapy / Follow-ups

Page 245
Web formation
Future treatment plan for ballooning
Vein size diameters – IJV/azygous/hemi-azygous/vertebral/lumbar/left iliac/IVC
Sedation and increased tolerance to meds / Stenosis correlation to which side
Trauma and azygous damage?

Page 246
Azygous web
Valsalva, reflux

Page 247
Vasalva, bulging neck veins
38% reduction of NEW lesions is normal?
Advice for people who don’t see improvement

Page 248
CCSVI and Zamboni criteria
4 CCSVI Pattern Types (see Squeakycat post)

Page 249
Azygous, Doppler, hemodynamic
Thyroid gland disorders
Stents and thrombosis, better angioplasty
Terminology – proximal, distal
Comment on external jugulars

Page 250
Getting Color Doppler Ultrasound done
B-mode vs Doppler Ultrasound, Duplex Ultrasound
The Interventional Radiologist

Last edited by AlmostClever on Mon Apr 18, 2011 5:50 pm, edited 28 times in total.
If you can't explain it simply, you don't understand it well enough. - Al Einstein

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Re: Dr. Slafani's Thread Index

Post by NHE » Sat Jun 26, 2010 6:02 pm


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Post by ms2009 » Sat Jun 26, 2010 7:08 pm

Thank you. Very nice and much needed.

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Post by elyse_peace » Sat Jun 26, 2010 9:39 pm

Hello, Almost Clever -
Thank you so much. :D Your work on the thread index is well done and is a huge favor.

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thank you!

Post by Kate_PghPA » Wed Sep 22, 2010 7:35 am

thank you for organizing the Sticky thread:

Sticky: Dr. Sclafani's Thread Index (Pages 1-218)

Now that possibility of Angioplasty draws closer I am reading Specifics on
this Hope-rendering procedure!
Venoplasty 12/26/10 Vas.Surg/ Pgh,PA Angio'd Both IJV

2/9/11 F/U Transcranial Doppler: flowing well
8/15/11 Hosp. Exac. "MS" 1st Spinal lesions EVER seen/ MRI
9/7/11 F/U T. Doppler: flowing well

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Joined: Tue Dec 08, 2009 3:00 pm

Dr Sclafani

Post by ACE » Mon Nov 08, 2010 2:27 pm

Hi Doc I dont know if you are not receiving my emails, but I am due for my 3rd Angoplasty soon and am hanging out for your take on my second Venogram that I sent you a few weeks back, have you received it and have you had time to review it?.....Alexander

Family Elder
Posts: 366
Joined: Mon Dec 21, 2009 3:00 pm
Location: Houston, TX

Post by AlmostClever » Wed Feb 23, 2011 4:56 pm

Page 251
Tests before treatment?
A Doppler Ultrasound interpretation
Thrombosis after ballooning

Page 252
Detecting thrombosis with ultrasound, treating clot
New symptoms after procedure

Page 253
Duplex Ultrasound, re-stenosis and thrombosis
The Jugular Problem – backflow and low-flow
Anticoaglation, Blood tests, INR, Coumadin, Warfarin, Fondaparinux
Problems treating Azygous, PPMS pattern

Page 254

Page 255
Blood flow
Jugular valves, 2 Types of Reflux

Page 256
SIR – Society of Interventional Radiologists
Cerebral perfusion, collateral veins, flow velocity past abnormality

Page 257
For the "Non-convinced"…
Upper narrowings = Lower problems (usually!)

Page 258
Jugular Vein Cross Sectional Delta
Doppler BEFORE and AFTER treatment
Thrombosis time window after treatment

Page 259
"mlrm" case update
Stenosis and Thrombosis – descriptions and diagnosis
Comments on "Extracranial stenosis is an unlikely cause of MS" study
Jugular CSA during inspiration and expiration

Page 260
Treating a patient who couldn’t lie still?
Dissecting MS cadavers to look at veins

Page 261
Restenosis and complications
Valves, Incompetent Valves
What constitutes a clinical narrowing?
Endothelin 1 levels, fibrosis, hypertrophy
Looking at the Haacke videos…

Page 262
Blood clotting and temperature / Exercise
Left VS Right Angio Entry / IVC role?
What causes clotting of the arm?
Balloon procedure example (with pictres)

Page 263
Stent fracturing
Balloon construction
When might you stent the iliac vein?
Neck entry
Complications of venoplasty
Backlash againat CCSVI?
Collateral veins and symptoms
Torn veins
Sweet Sweat!

Page 264
Hemi-Azygous and other smaller veins…
Blood Pressure
Standard balloon and pressure for jgulars?

Page 265
Back to work!

Page 266
Vein closure, Intimal Hyperplasia
Thrombosis, Elastic Recoil
Dynamic stenoses?
Azygos and spinal lesions?
Can clots become permanent?
Pain in treated jugular vein

Page 267
Checking for thrombosis
Elastic recoil from pressing?
Lymphatic ducts

Page 268
Medicare and coverage
Predictable improvements?

Page 269
Things to ask yourself…

Page 270
Picture of Azygous, Hemi-Azygous and Ascending Lumbar
Will I be worse after procedure?
Change a doc’s opinion?
Check for May-Thurner’s? / Cutting balloons
A little test…
Looks like CCSVI, smells like CCSVI…

Page 271
Answer to p 270 test
Symptoms, Diagnosis
Smaller veins and stenosis
Stenosed IJV, image and discussion
Trying to explain Fatigue

Page 272
Fatigue cont’d…
Chronic Fatigue Syndrome and CCSVI link?
CASE STUDY: Hypoplastic IJV

Page 273
Hypoplastic vein treatment, Jugular Vein structure
Deciding which side to treat / Contrast dye toxicity?
Standardizing symptom/result reports
"Cece’s" MRV
Beaking annulus
I treat based on CCSVI dx, not MS dx

Page 274
CASE STUDY: Hypoplastic Veins
MRV, Doppler / May-Thurner
Hernia repair an obstacle for treatment?

Page 275

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Page 286
Iron, Flap
Veins, Pressure and Volume
Case study improvements?

Page 287
Vascular doctors and such…
Following up…
Jugular Vein Case Study discussion cont’d
Blood thinners and aftercare?
Iron, Flap
Veins, Pressure and Volume
Case study improvements?

Page 288
Fondaparinux (Anixtra) and thrombosis
Elastic recoil, Thrombosis, Intimal hyperplasia, Fondaparinux and aspirin
Could it be arterial problem?
VEGF Vascular Endothelial Growth Factor notes
Thoughts on vein duplication
Determining between thrombosis,elastic recoil and intimal hyperplasia
Vascular doctors and such…
Following up…
Jugular Vein Case Study discussion cont’d
Blood thinners and aftercare?
Iron, Flap
Veins, Pressure and Volume
Case study improvements?

Page 289
Too early for Doc S. to determine outcome patterns
Note on jugular duplication
How to fix vein duplication?
No belief in side-blocked to symptom correlation
Follow up and re-treatment…
CASE STUDY: Azygos Vein

Page 290
Weak jugular, phasic nature problem
Case Study discussion
Burning a vein?

Page 291
Respiratory vein dynamics
3 hours!

Page 292
Valve issues
5 ways out – internals, azygos, vertebrals

Page 293
Speeding up the procedure…
Left femoral entry, May-Thurner
Restenosis? Thrombosis?
IVUS finding

Page 294
Liquid to inflate balloon
Treat 30% stenosis in azygos
"Occlusion Venography"
Can a jugular blood clot cause a stroke?
MS Lesion improvement?
Post-procedure improvement and worsening
"Silverbirch" question re: carotid sinus, rash
Occluded subclavian vein?

Page 295
Who to treat and why? Liability?
Blood tests, monitoring

Page 296
High EDSS? Treat’em
Stenosis beneath stent
Spinal cord drainage, Lumbar veins
Jugular vein and valves
Neck movement and blood flow
Why I don’t like stents…

Page 297
The stent question…
More circum-stentses
Destroying valves?
Vein replacement
Whole Body Vibration

Page 298
Valvular stenosis in azygos venogram

Page 299
Venography is better than Ultrasound is better than MRV
Elastic recoil, Valvular stenoses, re-treatment
CCSVI criteria but no MS lesions
Sample azygos venogram

Page 300

Page 301
The merit of MRI/MRV
Haacke MRV
What’s going on…
Hughes Syndrome
Second, third treatment?
Jugular vein stenosis venogram
Followup ultrasound
CCSVI and venography

Page 302
Avoiding damaging veins when dilating
Treatment during management of PML? Pregancy?
Interventional Radiology vs Surgery

Page 303
Treated siblings yet?
Reflux, Valvular obstruction
The Case of the Missing Cadaver Veins

Page 304
Cadaver vein pics found!
Reflux, valves
Diagnosing and treating
Reasons for procedure #2
Treating annulus vs fused leaflets

Page 305
Remove those clots quickly!
"I treat CCSVI, not MS!"
90% of my patients are first time
CCSVI treatment advice
Unnecessarily breaking the annulus
Balloon burst pressure, using 2 balloons

Page 306
Breaking annulus and thrombosis, balloons
Burst pressure, using 2 balloons

Page 307
Restenosis rate, azygous
Children and treatment
Putting a CCSVI venogram "recipe" together
Correlation of stenosis and disability

Page 308
NY Times article
CCSVI and aging?
Device to detect markers in blood from clotting?

Page 309
Drug coated balloon to prevent intimal hyperplasia
Improving and using collateral veins?
Ultrasound and azygous, vertebral veins, getting a bigger picture
Treating hypoplastic veins
Treated hypoplastic veins and clotting

Page 310
Hypoplastic vein story
Plastic valve
Top 10 (Improvements)

Page 311
Position and draining the brain
Clot in leg from pressure on insertion site
Techniques to open occluded veins
Nerve pain

Page 312
Things that cause clotting

Page 313
Notes from Italy

Page 314
Clotting and larger balloons
Strictured veins
Found inflamed optic nerve at eye exam…
Return of symptoms and restenosis
Physical therapy
Preventing occluded stents
More on thrombosis…

Page 315
Antiphospholipid syndrome (APS)
Pulling a balloon?
Do you guys share notes?

Page 316
Balloon sizing
Aspirin, ALS study
Advice for "Perkele"
No consensus on procedure

Page 317
Pre-workshop comments

Page 318
SIR meeting comments
"Liberation" image comments
MS and CCSVI symptoms, using MRI to measure disease progression/regression
Duplicate Zamboni’s MRI work?
Can a membrane and a valve case reflux?
Azygous pain after stent?
Balloon sizing
Treat only the valve?

Page 319
Inverted valve treatment
Scar, narrowing
More on "Liberation" images, IVUS vs inflating to find lesions

Page 320
Routine dilations to prevent restenosis?
Dural sinus stenosis
Stretching scars
If you can't explain it simply, you don't understand it well enough. - Al Einstein

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