PaulH wrote:
Dr. Sclafani,
(not meaning to hijack the thread) But I wanted to let you know that I'm doing great since you inserted that 8cm stent into my right jugular vein two weeks ago. No fatigue. All is very well.
Thanks again for being such a pioneer in this field.
Paul.
spectacular paul.
so interesting. i will share pauls story as he remains anonymous.
Delightful it is to hear about the improvement in symptoms
paul was treated with resolution of most major problems. then a few months later things reversed. Prompt ultrasound confirmed a problem with ccsvi and an occlusion was diagnosies. This was about four months after treatment but nonetheless, symptoms worsened quickly was an indication for aggressive followup
aggressive was I in addressing this deterioration of symptoms, within two weeks venography showed occlusion and i was able to do a rendevous procedure from above, open up the vein and stent an occlusion. If i had waited a few months (which i have in a few other cases), recanalization would have been doomed to failiure
the case very nicely illustrates the need for aggressive management of return of symptoms by ultrasound and venography.
Had i waited for a six month check, the vein would likely be lost and recanalization would have been impossible.
Donot wait passively by.
I am pleased that my patients provide me with good periodic followup. Those who are unable to travel to meet me on a routine basis, are asked to provide me with an email monthly. I pick up quite a few things this way.
I think i am using old and new ideas.