We will need some examples where treatment of mts AFTER treatment of unsuccssful treatmentof conventional ccsvi stenoses caused improvements. OR at least there has to be significant flow up into the ascending lumbar vein
Such as you have seen in the renal vein, in Nutcracker syndrome.
http://www.isnvd.org/files/ISNVD_Newsletter.pdf
Dr. Seshadri Raju discussed lessons from endovascular management of lower extremity venous obstruction.
Stents placed in the lower limbs show great patency over long periods of time. Symptom relief has shown to
be excellent, including ulcer healing. He mentioned that venography is not perfect in identifying venous
abnormalities and IVUS is much better. Specifically, he noted that vessel wall imaging using IVUS can
distinguish normal and abnormal vessel wall efficiently. This technique is essential in studying vascular
abnormalities, and can play an integral part in supporting the venographic MRI data, especially for the
azygous vein. Stenting in venous system is different than in arterial because of different pressures and flows.
Stents are better than balloons because balloons recoil of lesions. Iliac vein stenting is very good for treating
CVI. Collaterals will go away when larger pathway opens.
Dr. Raju states that IVUS is much better than venography at identifying venous abnormalities, specifically distinguishing between normal and abnormal vessel wall. But why would this be of importance especially for the azygous vein, and not as especially the jugular veins? Also when he notes that there is ulcer healing, if Dr. Zamboni's original assessment of our MS brain lesions as being like the ulcers seen in these other venous insufficiencies is true, then it could be that our MS lesions could heal once proper flow is restored.
