Retry with stent?

monkeyfighters · Post by **monkeyfighters** » Wed May 25, 2011 9:09 am

Hi everybody,
One of my best friend who lives in Europe was diagnosed with MS. Last December he traveled to Bulgaria and went through ballooning(?) whereas his neck vein (I think) was "stretched" if I use the word correctly.
However, he opted out of getting a stent. Initially, in the first couple of months he was a lot better the procedure seemed to work. His speech and balance was better. But now he gradually fell back to the state where he was before.
My question is shall he get a stent to achieve a longer lasting result? Should he wait for the new absorbable stent still under clinical trial or sick to the permanent one? Would be any better if I try to arrange a trip for him to the US and go through another operation here vs. Bulgaria?

Thank you very much for your help in advance.

dania · Post by **dania** » Wed May 25, 2011 9:42 am

Wait a little bit. They are finding out more info as they do more people. Dr Arata thinks this is a valve problem and he treats the valves by tearing them and also doing angioplasty.. There is a question about the size of balloons that should be used. Better that it is done the next time with permanent results. I have had it done 5 times and I am worse than ever as my veins are now 100% blocked with scarring due to having the procedure done. Everytime the vein is treated a little damage is done to the vein's wall.

esta · Post by **esta** » Thu May 26, 2011 2:36 pm

monkeyfighter
i would stick to poland's dr. simka in katowice, or go to warsaw. they know a great deal, and are on top of all of the newest devices, and would advise you of their opinion.
they have done the most procedures, i believe and have all their stats so your friend can make an educated decision when he feels he's ready...if he could wait, it might be better as their equipment seems to improve dailyit seems.

Cece · Post by **Cece** » Thu May 26, 2011 3:37 pm

monkeyfighters, if he had improvements and lost them, the assumption is that his veins restenosed. Restenosis can mean going back to their original shape or it can mean a complication, like a thrombosis or intimal hyperplasia, which is when the vein wall grows thicker in response to injury which reduces flow.

Without knowing the cause of the restenosis, we can't know if a stent is the right solution. Stents increase the risk of complications.

Bulgaria was the first place where people were complaining of pain with the ballooning and it was said at the time that they were more aggressive but that people felt this meant their veins would stay open longer. Now we know that more aggressive might result in more injury.

The resorbable stent that is under trial is too small for use in the jugular veins. So it'd be a matter of waiting for that trial to come through then waiting for them to make it in a larger size...might be a long wait.

Everyone here knows I am a fan of IVUS. This is intravascular ultrasound used to get images of the vein from the inside. Those IRs who use it say they are able to find stenoses that they wouldn't have found without IVUS. The doctors who use IVUS are Dr. Sclafani in Brooklyn, Dr. Cumming in Minneapolis, and Arizona Heart Institute in AZ.

monkeyfighters · Post by **monkeyfighters** » Fri May 27, 2011 8:21 am

Thank you very much everybody for all the information! It is very very helpful!!!

ozarkcanoer · Post by **ozarkcanoer** » Fri May 27, 2011 3:33 pm

I had stents in both my IJVs last August. One turned out fine but the other is completely occluded. And my procedure was performed by a top-notch IR in the USA. I would recommend patience stent-wise. Right now I am researching how this darned thing can be fixed, if at all

ozarkcanoer