Michael Chopp, keynote speaker, ISNVD 2012

[Cece]

ABSTRACT "Evaluation of Cerebrospinal Fluid Flow in Multiple Sclerosis Patients using Phase Contrast MRI" (Marcella Lagana, ITALY)

I am curious about what is being discovered about cerebrospinal fluid flow dynamics! Again I'd like to see before/after on patients being treated for CCSVI.

Cranial Instability and CCSVI (David Williams, CANADA)

Is this the same as what we've been discussing here lately? He is on the patient day program as well.

Postmortem assessment of jugular and azygos vein pathology (Robert Fox, USA)

Terribly interested in this! Go, Dr. Fox!

Neurovascular coupling and cerebral vascular organization (Kamil Ugurbil, USA)

Anyone know what neurovascular coupling means?

A Physics Link Between Cerebral Venous Reflux and Venous Hypertension, Hypoxia and Scleroses (Trevor Tucker, CANADA)

And, Go Dr. Tucker as well! I want to hear more about hypoxia, and of course more about the equations and hypertension.

[Cece]

Keynote Speaker: Investigating the vasculature of the eye. (Timothy Q. Duong, USA)

If venous congestion can be seen in the fundus of the eye, that is measureable and verifiable. Very interested in the work being done regarding eyes. Dr. Simka is moderating, and if you remember, Dr. Simka did a study on OCT of the eyes for last ISNVD.

Dr. Diana is in here with a presentation too!

CCSVI – The Eyes Have It (Diana Driscoll, USA)

Then on to the abstract presentations!

Recanalization of the jugular vein and CCSVI (James F. McGuckin, USA)

Does he mean recanalization after a thrombosis after CCSVI treatment? Or is he talking about recanalizations that lead to tiny veins that could be mistaken for hypoplasias, that might be found when a patient is first assessed for CCSVI? Either way I'm interested. I'm guessing it's the first.

CCSVI in MS is Characterized by Altered Collagen Expression in Draining Veins in the Brain (Matteo Coen, SWITZERLAND)

But did we start off with altered collagen expression, or is it a result of the chronic reflux conditions and altered shear stress?

[Cece]

ABSTRACT "Quality of Life Changes After Endovascular Treatment for CCSVI in Patients with MS" (Kenneth Mandato, USA)

That's Dr. Mandato of Dr. Siskin's group in Albany. These are results from their trial?

ABSTRACT "Internal jugular vein valve morphology in patients with CCSVI; angiographic findings and schematic demonstrations" (Mamoon Al-Omari, JORDAN)

Yes, let's talk about the shape of our jugular valves. Is mishapen a shape? Triangle, square, rectangle, hideous?
Schematic demonstrations...yes, I'm interested in this one. My left jugular valve had a very big flap extending across the jugular. I suppose morphology could be as simple as being thickened.

Ok, now that you sat through that, here I found a paper by Dr. Al-Omari on IJV morphology.
http://members.sirweb.org/members/misc/AlOmari.pdf
Some examples of morphology seem to be:
stenosis
flap (IJV)
flap (BCV)(what's a BCV?)
ectatic carotid bulb
abnormal valve
diaphragm/membrane

[Cece]

ABSTRACT "The Cerebral Perfusion Patterns of Patients with Multiple Sclerosis (MS) using MRI" (Yi Zhong, USA)

This is interesting, but I wonder if the cerebral perfusion patterns correlate with the location and severity of the outflow obstructions?

ABSTRACT "Intravascular Ultrasound for detection of azygous and internal jugular vein (IJV) abnormalities as part of the PREMiSe (Prospective Randomized Endovascular Therapy in Multiple Sclerosis) study" (Yuval Karmon, USA)

Is this the BNAC study? I think it's the BNAC study. Yes! An IVUS study! I am guessing the results are that IVUS enabled them to find more intraluminal abnormalities and to better identify each intraluminal abnormality than flouroscopy ever could. Can't wait to read this one.

ABSTRACT "Measurement of Azygos venous blood flow in patients with Multiple Sclerosis using MRI" (Aisha Tai, USA)

It would be very good to have an effective noninvasive means of measuring the azygous flow for patients with azygous disease.

[HappyPoet]

Some examples of morphology seem to be:
stenosis
flap (IJV)
flap (BCV)(what's a BCV?)
ectatic carotid bulb
abnormal valve
diaphragm/membrane

Maybe BCV = Brachiocephalic vein (innominate vein).

[Cece]

HappyPoet, I forgot to reply, but when I saw that, I thought that was right.

Three new speakers for ISNVD:

NEW! Additional speakers for ISNVD Patients Day in Orlando on February 18th.
Dr. Dan Simon - "Managing Thrombosis"
Dr. Jack Burks - " Collaboration and Healthcare Reform"
Dr. Kirsty Duncan - "Fighting for Clinical Trials in Canada"

Everyone knows Ms. Duncan and her efforts in the Canadian government.
Dr. Burks recently presented at ISET and is a neurologist. Here he is presenting at the Hubbard conference last spring:
Dr. Simon is an interventional radiologist at Vascular Access Centers in NJ. Here's a NYTimes article from a year and a half ago in which, along with other IRs, were interviewed. http://www.vascularaccesscenters.com/Up ... 0Times.pdf and here he is in a video that was on CNN: http://thinkccsvi.com/daniel-simon-md/

[Cece]

http://thinkccsvi.com/

A picture of the Doctor's Roundtable, with Dr. Sclafani third from the left, and other notes on ISNVD from Danielle Rheume! Thank you, Danielle!

So what has happened so far at ISNVD? Today was Patient Day, and there was a webinar, and I did not have the day to devote to watching, although I wish I could have! Did anyone catch it who wants to give the highlights?

At the same time as Patient Day, there was a Consensus Workshop on Vascular Imaging in CCSVI: Ultrasound Session led by Dr. Haskal and Dr. Zamboni himself with these presentations:
1:00pm-1:10pm Welcome (Robert Zivadinov, USA)
1:10pm-1:30pm Consensus on US CCSVI screening criteria (Sandra Morovic, ITALY-CROATIA)
1:30pm-1:50pm B-mode abnormalities and wall stenosis in the natural history of MS (Karen Marr, USA)
1:50pm-2:10pm The diagnostic value of CCSVI criteria (Angela Lagace, CANADA)
2:10pm-2:30pm Does thoracic pump influence cerebral venous return? (Erica Menegatti, ITALY)
2:30pm-2:50pm A prospective study comparing ultrasound and angiography (Marian Simka, POLAND)
2:50pm-3:10pm A Hemodynamic Model for Quantification of Cerebral Venous Return (Sandra Morovic, ITALY-CROATIA)

and then a Consensus Workshop on Vascular Imaging in CCSVI: MR Imaging Session led by Dr. Dake and Dr. Haacke.
3:40pm-4:00pm Magnetic resonance imaging CCSVI protocol (J. Joseph Hewett, USA)
4:00pm-4:20pm Morphological MRV multimodal studies in CCSVI (Robert Zivadinov, USA)
4:20pm-4:40pm Flow quantification (Michael D. Dake, USA)
4:40pm-5:00pm MS, MRI database (E. Mark Haacke, USA)
5:00pm-5:20pm Multimodality comparison and jugular entrapment syndrome (Paolo Zamboni, ITALY)

I have learned to pay attention to anything Dr. Zamboni says. At the last ISNVD he brought up plethysmography, which is brilliant. Here he talks about multimodality comparison and jugular entrapment syndrome. I am not finding any easy information on what jugular entrapment syndrome is, or how it might affect our understanding of CCSVI.

[Cece]

https://twitter.com/#!/search/realtime/isnvd

"What we should be doing in neurological disease is remodeling and treating the existing/healthy/intact tissue." -ISNVD Michael Chopp MD

I am not sure what he means by that.

[Cece]

www.isnvd.org/files/ISNVD%20Abstract%20 ... Remodeling the Brain after Stroke and Neural Injury (Michael Chopp, USA)

Historically, the focus of the treatment of stroke and neurological injury and disease has been neuroprotection,
i.e., reduction of damage to brain. However, a more fruitful approach which may permit the efficacious
treatment of all patients is to treat, not the injured tissue, but the intact brain, in order to stimulate and amplify
endogenous restorative mechanisms which promote neurological recovery. In this presentation, I will describe
our work on cell-based and pharmacological-based therapies for the treatment of stroke and demonstrate that
a major neurorestorative pathway is via the vascular system. Effective treatment of neurological diseases
stimulates vascular changes which in-turn amplify and couple with other restorative events, such as
neurogenesis, to promote neurological recovery post stroke.[/quote]
Here is what he means. Brilliant.