DrSclafani answers some questions

[1eye]

I did not mean you don't count. To a huge number you do count, a lot more than all the politicians put together. I hope you know I know that, and that I am one of them.

[TMrox]

Dear Dr Sclafani,

Have you read the German and Swedish studies commented in the Wall Street Journal?

http://online.wsj.com/article/SB1000142 ... 10380.html

Did these studies use the doppler ultrasound with the right protocols?

By the way, I found this picture quite amusing. Rox

[selkie]

Dear Dr Sclafani,

Have you read the German and Swedish studies commented in the Wall Street Journal?

http://online.wsj.com/article/SB1000142 ... 10380.html

Did these studies use the doppler ultrasound with the right protocols?

By the way, I found this picture quite amusing. Rox

I posted these articles earlier. Dr. S hasn't responded yet - doesn't mean he's not aware, and I'm sure the doctors who actually care about MS patients will have something to say about them, but probably directly to those papers.

[TMrox]

Thanks selkie, I did not see your earlier post. There are so many posts in this thread. Obviously we all want to get the point of view of Dr Sclafani

Sorry Dr Sclafani, just skip my question but I hope you like the pic!

Rox

[AlmostClever]

Hiya Doc!

Been working my way through the symposium vids and had a few questions:

Doc Siskin mentions they developed their own "flared" stent.

Is the use of flared stents going to be the standard and how much of a flare are we talking about? Flared which way - up or downstream? Can other docs do this?

Is it possible to stent around a curve?

What keeps the wire from damaging the inside wall of the vein? How do you steer? How thick is the wire?

Thanks!

A/C

[Cece]

to be honest, as i hope i will always be with you, i did not suspect that such abnormalities were common in the azygous. Sinan used the balloon as a diagnostic tool to "feel" around in the vein. the narrowings were impressive. It was one of the major points i took away from the meeting

Any other major points that we have yet to touch on?

Not a good time for a vacation, maybe keep it short and hurry back to us?

[ACE]

Not a good time for a vacation, maybe keep it short and hurry back to us? [/quote]

Personally I think anytime is a good time for a vacation, and god knows you must deserve one......so make it long and thoroughly enjoyable......cheers
PS.......Dr Bester, in Sydney told me that he is keeping up with all your papers on CCSVI we can only go up and beyond from this point.......ACE

[japentz]

Forgive the question here, but was their a professional video done of the July 26th symposium?

Videos were posted on YouTube by DrBartman, but the sound and voices are hard to hear and the visuals in the presentations were not in these videos.

sorry for this being in the wrong place, but I figured it was a question to Dr. Sclafani, who has been so very kind.

Thanks
Judy

[hope410]

Doctor, why is there such diversity regarding the use, if at all and for how long, of blood thinners/anti-coagulants after the procedure?

Is this kind of disparity typical, i.e., when docs have done angioplasty on arteries or veins in the past, is there this kind of difference in opinion on post-treatment meds that has always existed? Or is this unique to CCSVI treatment that there's such a difference in post-tx meds? Thanks. I think many of us are worried about the risks of blood thinners versus the risks of thrombosus, and feel insecure with the differences in medical opinion on tx & for how long and with what vs. no tx. With stents, should blood thinners ALWAYS be used because of the higher risk of clots? Is it absolutely indicated where no stents are used?

Please enjoy a wonderful holiday and thank you for putting on such a successful symposium!

[girlgeek33]

Doc Siskin mentions they developed their own "flared" stent.

Is the use of flared stents going to be the standard and how much of a flare are we talking about? Flared which way - up or downstream? Can other docs do this?

A/C

So this doesn't confuse issues, because FDA approval gets involved in brand new medical devises, he didn't develop a new stent. He is using multiple size stents together to come up with this effect. Great creativity to work with existing devices to solve issues!

[logic]

Dear Dr S,
Many thanks for The Symposium a week ago!

Another technical question, I don't think it has been much discussed so far:
- What pressure is being applied to the balloons - are there different cathegories of baloons based on pressure?

pressures generated are between 8 and 30 atmospheres. That is the equivalent of the pressure of the ocean on top of you 1000 feet under the surface. It is a lot of pressure. Fortunately it is contained within the balloon.

Hi Dr. Sclafani. I have been studying scuba for three years. I am now 12 years old. My mom is bluesky63 and I am very glad that you are helping her. My mom showed me this after her venogram.

I hope you won't mind if I point out that your example of pressure was not quite accurate because in that depth the perception would be more like density squeezing you more tightly, not like the weight of the ocean, plus the pressure would crush you. It's not a solid object that would press down on you. It's liquid but it has less oxygen at that depth, which makes it more solid, but still not solid, and the farther you descend, the greater the density. Do you have a different and more realistic example that I could understand?

Thanks for your time!

[1eye]

This was posted under the name Edward Murray on "The Medical News"

How insightful and as the Anals noted, "important."

How does it advance the science of this if you don't actually attempt to replicate the work of Dr. Zamboni?

I personally tested the CCSVI theory using tarot cards and was "not able to reproduce the findings by Zamboni et al. " I should submit my results to the growing evidence that CCSVI is not real at least when you don't actually test for it.

Tarot has been shown to be unfocussed and inaccurate compared to the more professional parapsychological methods such as Ouija. Never or nonetheless, it fully agrees with this finding.

Zamboni has said on many occasions that researchers, especially those at financial or mental risk, should continue taking their medication.

"Time is brain, and, as we all know, also money, so the conclusion might be reached that brain is money, but we're still not sure." said Dr. Gamblumer of the Hospital for Sick Billionaires, where he is Chief of Neuro-Phrenology.

CCSVI has again been described among the cognoscenti as "unreal".

[Donnchadh]

Hi Dr. Sclafani,
this is a side view of my jugular veins. The right one(on the left side of the picture) is obviously narrower.What concern me is that there are 2 collateral veins that take over right after the jugular vein exit the bony ostium.
I think they are collaterals because they insert at 90 degrees to the main vein.
1: Do you agree that they are collaterals?
2: Is it safe to balloon collaterals considering they usually are smaller and more fragile veins? Have you seen a similar situation in the past?
Thanks again for your expert opinion.

I am NOT a doctor (nor do I play one on TV) so my opinion is next to worthless.

After looking at your image, I am wondering if your IJV flattens and twists as it goes down???? Also it seems that there are collateral veins splitting off from the sigmoid sinus.

Donnchadh

[THEGREEKFROMTHED]

Sal,
question regarding doppler ultrasound. The technician who performed my ultrasound worked for a vascular surgeon and was quite familiar with venous system and IJV's. She commented on the reflux at the base of my neck as "interesting" but said that she typically will see some reflux in normal subject and considered it as such. Is some degree of reflux normal? How does one measure the degree of reflux with regard to abnormality?

[Cece]

Not a good time for a vacation, maybe keep it short and hurry back to us?

Personally I think anytime is a good time for a vacation, and god knows you must deserve one......so make it long and thoroughly enjoyable......cheers

I agree, I was just trying to respond to the faces...not the usual faces one makes when contemplating vacation.

Sorry if this is chatter! More questions, quick:

* When googling high pressure catheter balloons, it brings up differently shaped balloons: dogbone, square, etc. Would there be any use in CCSVI for balloons of a different shape? I have no idea what they're for.
* Did Dr. Sinan talk any more about valvulotomy? Does it seem like valvulotomy is acceptably safe?