Reader response: Safety and efficacy of venoplasty in MS.
Aldo Bruno, Vascular Surgeon, Vascular Department, Gepos Clinic

About Traboulsee et al.'s procedures,1 I have some questions: What was the material the radiologists employed? The criteria to determine the stenosis was very reductive so to affirm the presence of stenosis: only when you observe a >50% narrowing of any of the 3 veins. However, as the Journal of Vascular and Interventional Radiology guideline described,2 that I followed for my patients, it is also necessary to evaluate the empty time and the reflux of the blood in the internal jugular veins and azygos vein (the presence of intrinsic lesions; the presence of collateral veins with empty time). I have not found the diameter of balloons employed and inflation time too brief. I inflate the balloon for 120 seconds and sometimes repeated venoplasty after persistent narrowing.2,3 I had no major adverse events in all patients and only minor adverse events in 5 patients treated with conservative therapy.3 So, I can affirm, PTA of the internal jugular veins and azygos vein is sure and risk of adverse events is low.

http://n.neurology.org/content/reader-response-safety-and-efficacy-venoplasty-ms

My experience was not promoted through social media, but my papers and presentations at international conferences received an international diffusion: International Society for Neurovascular Disease conference; Italian Society of Otorhinolaryngology; Society of Interventional Radiolofy meeting; Inte...