Left Renal Vein, you're so vein you probably think this song

[Cece]

...is about you

http://thinkccsvi.com/2012/01/20/lrv-yo ... about-you/

Some thoughts on renal vein stenosis, from a website put together by VAC. According to this page, a stent is rarely necessary, and ballooning is successful at opening up these renal vein compressions. I have heard the opposite from other doctors, including Dr. Sclafani and Dr. Arata. Who is right?

Included in that page is a link to their renal vein stenosis (nutcracker) page.
http://thinkccsvi.com/nutcracker-syndrome/
Have I mentioned how much I love CCSVI images!

[drsclafani]

...is about you

http://thinkccsvi.com/2012/01/20/lrv-yo ... about-you/

Some thoughts on renal vein stenosis, from a website put together by VAC. According to this page, a stent is rarely necessary, and ballooning is successful at opening up these renal vein compressions. I have heard the opposite from other doctors, including Dr. Sclafani and Dr. Arata. Who is right?

Included in that page is a link to their renal vein stenosis (nutcracker) page.
http://thinkccsvi.com/nutcracker-syndrome/
Have I mentioned how much I love CCSVI images!

Cece
I have reviewed the world literature on several occasions. The most common treatment of nutcracker is surgical transposition of the kidney or renal vein. There are very few cases of angioplasty as effective treatment. I could find no long term followup after angioplasty but there are several papers on followup of stenting which is written about with increasing frequency. Well described in May thurner syndrome, recurrent stenosis is likely after angioplasty alone because the constricting forces are not addressed by angioplasty.

but thanks for the stimulation to repeat again my review. I now found among the clinical symptoms associated with Nutcracker, mention of "myelitis" no doubt due to ccsvi.

[Cece]

I noticed that mention of myelitis. After seeing you mention it too, I checked here:
http://www.phlebolymphology.org/2009/07 ... -syndrome/
which made the same statement about myelitis and syringomyelia as a very rare symptom of nutcracker, with this as the citation:
http://www.ncbi.nlm.nih.gov/pubmed/3717902

Ann Urol (Paris). 1986;20(2):137-41.

[Responsibility of the left renal vein and inferior vena cava in certain cases of myelitis and syringomyelia. Value of ligation of the venous reno-spinal trunk. Apropos of 30 cases].

Frantz P, Jardin A, Aboulker J, Küss R.

Abstract

Certain diffuse forms of myelitis may be due to raised intra-spinal venous pressure resulting in veritable "varicose veins of the spinal cord". The origin of this increased pressure is often multifactorial, but may be due to venous reflux of blood from the left kidney into the intraspinal plexuses via the reno-spinal trunk. Ligation of this trunk results in a considerable and often complete improvement in the neurological syndrome. This operation was performed for the first time by our team in 1973 and since then has been successfully performed on 30 occasions for 21 cases of myelopathy and 9 cases of syringomyelia.

[1eye]

I found the part about medications interesting:

* Daflon 500 mg (MPFF) is also registered under various trade names, including: Detralex,
Arvenum 500, Elatec, Alvenor, Ardium, Capiven, Flebotropin, Variton, Venitol, Viatec

[DrCumming]

Sal, are you primarily stenting these patients or trying angioplasty first?

[drsclafani]

Sal, are you primarily stenting these patients or trying angioplasty first?

mike, i am stenting them primarily since my first angioplasty alone experience was a failure.

Criteria for stenting include extensive collaterals, symptoms (which include ccsvi symptoms), compression to near occlusion as seen on IVUS and pressure gradients greater than 3mm.

[DrCumming]

Sal, are you primarily stenting these patients or trying angioplasty first?

mike, i am stenting them primarily since my first angioplasty alone experience was a failure.

Criteria for stenting include extensive collaterals, symptoms (which include ccsvi symptoms), compression to near occlusion as seen on IVUS and pressure gradients greater than 3mm.

have you had any stent failures? if you do have one, what is your back up plan?