Thanks Dr. S,drsclafani wrote:Nigel, I've come to the conclusion that Dr. Arata needs the ever elusive superIVUS that has been discussed here before. (A new improved IVUS intravascular ultrasound that is 10 time sharper than old IVUS.) He is ballooning the area of the valves, as are all the IRs, although he is ballooning valves that appear normal, which is different than all IRs. Normal healthy valve leaflets are too thin to show up on regular IVUS. With the new better IVUS, we could get a moving image of these supposedly normal valve leaflets. Either they are indeed normal or they are thickened as is seen in MS or they might be dysregulated so that the flapping is not in sync. This dysregulation of valve leaflet motion could be a result of the dysautonomia and could contribute to flow disruption, which could explain the improvement Dr. Arata has seen when these valves are ballooned. It is at least a way to investigate but the new IVUS is needed.
OK Dr. Sclafani can have his thread back now. Sorry for too many posts!Do the thickened valves flap around or cause the vein to vacillate on a point? If they do, I wonder if they couldn't disrupt nerve transmissions the same way an artery can when it compresses a nerve. Maybe that's why ballooning functioning valves works...they'd have to be thickened or abnormal in some way though. If this is the case, then it would be the removal of a chronic mechanical stimulation rendering some of the PTA improvements (rather than the addition of mechanical stimulation during the ballooning event).the thickened valves are pretty much immobile in a fixed closed position. That is what is causing a stenosis.
what do you mean by an artery compressing a nerve. Aneurysms compress nerves but give me an example of an artery that compresses a nerve.
veins are highly complant structures of very low pressure. The idea that they could compress a nerve make no sense to me.The valve IS the stenosis. The surrounding vein is almost always normal. the "vibrations" are not like your power toothbrush. They arent vibrating like that. I think oscillation might be a better term, but lots of our body vibrate, the hairs in our nose, the valves ini the heart and other valves as well,Here's an example of neurovascular compression.
http://radiology.rsna.org/content/early ... 00477.full
I no longer have the misguided idea that veins can compress a nerve (ty)...I'm working with a new misguided idea. Could the higher frequency vibrations of the thickened (if they behave like stiffened/calcified) valves travel through to the vagus and impact nerve transmission or tone?? Would it be a bit like a tuning fork on the nerve?? (I don't think this would be a major player in PTA...but maybe a sidenote, something to look for if room for improvement remains? Trying to make sideways sense of Arata's focus on the vagus at the valves.)
Edit:
Vibration and vasospasm??? http://www.thisisms.com/forum/chronic-c ... ml#p207530 When you balloon valves, do surrounding stenosi typically resolve? Is zamboni having better results with his valve clipping tool?
Edit 2:
Could some restenosi be caused by leftover valve parts starting to vibrate again?
i think this vibration thing is another out of control urban legend waiting to happen
The restenosis is just adhesions at the sites where the valve was torn or stretched.
I thought there was a difference between a bad valve and a stenosis. I thought wrong.
There's absolutely no evidence to support the vibration idea. Plus, its just not as exciting as the stolen organ black market stories. How could it go urban legend?? I'm not even close to convinced. It was just a line of questioning about a possibility (which seems not to be a possibility).
