% definition of technical failure of vein angioplasty

[Cece]

http://www.sciencedirect.com/science/ar ... 140602297X

Primary patency was defined as a patent central vein without recurrent stenosis or the need for further intervention within the central veins. Assisted primary patency was defined as a patent central vein that underwent further intervention to improve patency. Loss of patency was defined according to accepted reporting standards.

Technical failure was defined as <50% gain in luminal diameter. Early failure was defined as an inability to cross the lesion at the time of the primary procedure or by the presence of an occlusion or ≥50% restenosis within the first 30 days after the initial procedure.

Residual stenosis was defined as ≥30% remaining stenosis at the conclusion of intervention in comparison to adjacent, nondiseased vein.

This is from a study on central venous stenosis but I thought it was of interest in regard to the PREMiSe study. There should have been a definition of technical failure of the angioplasty itself. And, when the angioplasty was a technical failure, then conclusions could not be drawn from it.

Endovascular therapy with PTA or PTS for central venous stenosis is safe, with low rates of technical failure. Multiple additional interventions are the rule with both treatments. Although neither offers truly durable outcomes, PTS does not improve on the patency rates more than PTA and does not add to the longevity of ipsilateral hemodialysis access sites.

This quote was interesting to me only in our own experiences too, with CCSVI, that some people have had multiple additional interventions and maybe that's not such an unexpected thing.

[PointsNorth]

It would be interesting if they could nail down the cause of re-stenosis. Is the cause of the original stenosis causing the re-stenosis as well.

[1eye]

I think there are some words on this in Dr. Sclafani's topic/archives and perhaps elsewhere. Like "MS", I don't think we know the whole story. You could throw up your hands and say, any kind of semi-surgical intervention has a host of possible bad outcomes, but there just might be something interfering, or causing both the original and the re-stenosis. That would mean this is not a congenital problem, but maybe the action of another life-form. I think it is interesting that lesions, black holes, webs, septa, Dawson's fingers, swollen ventricles, are all macroscopic, visible to the naked eye. Wouldn't it be great if we could catch some kind of critter in the act?