From Dr Arata
CCSVI is an abnormality of the jugular or azygous veins. It can involve all or just one of them. It is caused by abnormal valves in the primary form. Secondary CCSVI is a result of compression of one or all of these veins by adjacent structures. Azygous valves can be very difficult to detect which is why we often empirically treat the azygous.
Additional veins such as the vertebrals, lumbars, renals etc do NOT cause CCSVI. The do serve as collateral veins. Proper treatment dictates correction of the jugular or azygous problem. NOT Venous agioplasty of Collaterals.
I would like to take the opportunity to reinforce what I tell every patient of mine. If at anytime you have questions or concerns please contact me. I cannot discuss individual patient care issues in this forum. I am however always available to communicate with any patient directly.
I would prefer patients to have this procedure once and only once. That is why I THE most important thing when choosing a center is the quality, based on experience and outcomes, NOT the proximity or ease of scheduling. Patients have to understand that their first treatment is their best opportunity for a good result. Even when going to the best physician second, third or fourth procedures will not generate as good a response as the first treatment. I will continue to do the best I can to help people who have been treated elsewhere. Waiting a specified period of time, despite what happens to the ccsvi symptoms, is a simplistic and antiquated view of CCSVI. Retreatment is indicated anytime after complete relapse of ccsvi symptoms is present.
Flow is everything. CCSVI is not about narrow veins!
Question someone asked was "if the azygous vein is blocked off does this usually mean the jugulars are too? is it more common that way or is it usually just one set thats bad?"
Answer from Dr Hewett
There is really no predicting who will have a problem with any given jugular or azygos. Certainly the majority of patients have a problem with the azygos but not all. I think the most important considerations are that about 90% of patients with MS will have a venous abnormality, that the azygos should be thoroughly checked in all of them, and that many azygos veins look normal from a superficial inspection but upon closer evaluation a large number of these veins have a functional/treatable obstruction (we see a lot of these).
How many People have been treated in Canada and seen some Benefit?
Answer From Dr.Arata
I do not have exact numbers off the top of my head. I personally average 20 CCSVI procedures a week. I have been doing it for over a year. If not the most, certainly one of the most experienced in the world.
Benefits have to be define carefully. Many people speak in terms of MS. Despite patients often experiencing relief in MS symptoms we are treating CCSVI. A venous disorder with its own symptoms. Improvements in CCSVI symptoms occur in over 90% of patients after treatment. The non-responders are becoming more predictable. For example if severe compression of both jugulars is seen at the C1 level this is increased risk of lack of response.Additionally, rapid restenosis often occurs when the jugular valve is to small.
Question Someone Asked
Do people here take baby aspirin post angio? My friend who had her treatment else where was recommended it and I keep hearing more about this and am curious about this. Just started to research it more tonight. Curious about thoughts around this.
Answer from Dr.Arata
Anti-platelet agents, aspirin being one of them have not been shown to prevent venous clotting. This has been studied far more than ccsvi itself. The available evidence would suggest increased risk of bleeding if anything. Recommending them following treatment for ccsvi would be counter to available data.
Question; Do you check for the Iliac
We screen patient for it and if symptoms we do venogram. Treat all US patients and ask all others if they want to be treated.
What we don't do is radiate the pelvis of patients without symptoms.
Question:I have purple feet "Iliac"
Purple feet are typically the result of autonomic dysfunction. It is usually accompanied with coldness of the extremity. It is a symptom of CCSVI. When CCSVI is treated it responds. Cold purple extremities can be caused by other diseases also. When isolated to the left leg it can be secondary to iliac vein compression however this is not associated with CCSVI in any way.
Question:My titinus is loader then before treatment
Tinnitus is often described by patients with CCSVI. It typically resolves like other CCSVI symptoms when the jugular valves are treated. It also can return if a patient experiences a CCSVI relapse. Involvement of the sinuses is actually quite rare. The presence of tinnitus doesn't mean you have sinus vein issues.
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