Is this the my Left Illiac Vein?

dc10 · Post by **dc10** » Sun May 08, 2011 7:13 am

Here is an image from my procedure., and wanted to knowe if this is my left illiac vein:

I remember the doctor saying there is some indentation in the left illiac vein but its not May Thurner.
But my left leg is very weak compared to the right and i have left foot-drop but my right leg i ok, but saying this i dont have any swelling.

Thanks

dania · Post by **dania** » Sun May 08, 2011 12:44 pm

Ask Dr Sclafani.

Cece · Post by **Cece** » Sun May 08, 2011 1:57 pm

Or Dr. Cumming too.

The top image is labelled Internal Left Jugular.
The bottom images seem to include the ascending lumbars and other veins, perhaps including the iliac?

According to the ccsvi.org interview with Dr. Siskin, his group has found asymptomatic MT syndrome in 17% of pwMS (which is in line with what it is in the normal population.)

dc10 · Post by **dc10** » Sun May 08, 2011 2:35 pm

oops thanks for pointing that out cece.

i will try one of the doctors thanks

even though i dont have the leg swelling MT symptom, my left leg is a lot weaker than my right keg, could this be a sign of MT?

drsclafani · Post by **drsclafani** » Sun May 08, 2011 7:49 pm

dc10 wrote:oops thanks for pointing that out cece.

i will try one of the doctors thanks

even though i dont have the leg swelling MT symptom, my left leg is a lot weaker than my right keg, could this be a sign of MT?

your leg weakness is likely resulting from neurological injury, not from the compression of the vein

Cece, those are branches of the internal iliac vein, they are not the ascending lumbar vein which ascends from the iliac vein and connects with veins along the lumbar spine and may enter the hemiazygous vein.

it is an important vein when there is azygous disease

the compression of the iliac vein by the aorta is the may thurner syndrome. to properly make this diagnosis the venogram should be done on your belly to relieve that pressure. it is an important entity even in the absence of leg swelling because when this vein is obstructed, blood from the pelvis and leg must travel through collateral veins. Yep, one is the ascending lumbar vein and so this collateral increases flow through the aygous system, not a good thing when the aygous is already blocked.

dc10 · Post by **dc10** » Mon May 09, 2011 12:26 pm

thank you Dr Sclafani for your reply.

I am due to have an MRV next week, looking at the above images is there any area on the left illiac vein i can tell the IR to look and possibly balloon/stent ?

- i will ask him to check for May Thurner when positioned on my stomach.

i had mid-azygos stenosis (95% blocked) which was ballooned

- - as i have lumbar vein hypoplasia can this be treated by balloon dilation?
if so, i will mention this to him

Here is a picture of my illiac vein from my 2nd procedure, again is there any areas i should point to for him to check and possibly treat:

This time i will stress that he must be thorough as a different IR (no names mentioned) thinks i have MT (based on images i showed you before of my frst MRV)

thank you

dc10 · Post by **dc10** » Tue May 10, 2011 8:16 am

bump

dc10 · Post by **dc10** » Wed May 11, 2011 8:15 am

drsclafani · Post by **drsclafani** » Wed May 11, 2011 9:01 am

dc10 wrote:thank you Dr Sclafani for your reply.

I am due to have an MRV next week, looking at the above images is there any area on the left illiac vein i can tell the IR to look and possibly balloon/stent ?

having mid azygous stenosis is highly suspect in my opinion. Often it looks stenotic but it is a phasic narorowing. Ask if there was any waist on the balloon.

nonetheless, if it was ballooned and the vein is nicely opoen now, that is great.
all the more reason to clarify whether this is may thurner or not.

but why are your two images so grossly different?

I think it is in the technique of performance of the iliac veinography. The first time, catheteriation was from the right and the cathter was advanced from right to left. the tip of the catheter is facing toward the feet and it likely has its tip in the internal iliac vein, leading to the visualization of the pelvic veins. .. in the second one, the catheter is facing toward the head. and positioned in the external iliac vein. thus the branches of the internal iliac vein are not opacified.

I now question the diagnosis of MTS

but you got to check it out, perhaps the MRV can be done prone.

dc10 · Post by **dc10** » Wed May 11, 2011 12:00 pm

this was my before and after azygos ballooning:

Does this look satisfactorily dilated to you?

You are quite right, the two images are different because in the first image the right groin was entered and in the 2nd image the left groin was entered.

But doesnt the indentation on the second image show MT?

- i will request for the MRV to be performed when i am lying on my front

Here are 2 short videos of the 1st procedure showing contrast dye through the left illiac vein (i think) (right side entry) :

Im now approaching my 4th MRV i really hope someone gets it right this time - fortunately this time it will be free on the NHS.

Thank you Doctor

drsclafani · Post by **drsclafani** » Wed May 11, 2011 3:54 pm

dc10 wrote:this was my before and after azygos ballooning:

Does this look satisfactorily dilated to you?

You are quite right, the two images are different because in the first image the right groin was entered and in the 2nd image the left groin was entered.

But doesnt the indentation on the second image show MT?

- i will request for the MRV to be performed when i am lying on my front

Here are 2 short videos of the 1st procedure showing contrast dye through the left illiac vein (i think) (right side entry) :

Im now approaching my 4th MRV i really hope someone gets it right this time - fortunately this time it will be free on the NHS.

Thank you Doctor

those views are frontal. on the frontal view the entire arch of the aygous is looked at en face. you cant see it. This is where most azygous lesions are located in my experience.

dc10 · Post by **dc10** » Thu May 12, 2011 8:32 am

hanks Doctor S i will make sure he checks my left illiac vein and azygos when i am lying on my stomach,

looking at these 2 short (10second) video of my left illiac vein, do you see any areas i should request the IR to check?

Many thanks

Cece · Post by **Cece** » Thu May 12, 2011 9:42 am

I never had to lie on my stomach during the procedure, dc10. The equipment itself can be moved to take views from different angles.

It is so hard for people seeking treatment from docs who are not fully experienced, of which few are. CCSVI is very new.

Wishing you all the best with your next procedure!!

dc10 · Post by **dc10** » Fri May 13, 2011 1:54 pm

did the doctor check for May Thurner?
i thought laying on your stomach when checking for May Thurner/Azygos was the best way

is there anything i should ask the IR to check which could be a problem for CCSVI patients?

as its my 4th MRV (3rd procedure all balloon angio) i cant afford for a Dr to miss things again

thanks cece for your kind words, lets hope its 4th time lucky