Venöse Multiple Sklerose Hypothese | CCSVI

Dr. Salvatore J. A. Sclafani, Chief of Radiology Kings County Hospital in Brooklyn, New York, Professor and Chairman of Radiology at the SUNY Downstate Medical School beantwortete medizinische Fragen auf ThisIsMS.com.

Zusammenfassung:

• PDF: dr_sclafani.pdf
• Source file: http://www.impact-ltd.ca/dr_sclafani.doc

Original ThisIsMS postings: http://www.thisisms.com/ftopict-10680.html
Source: CCSVI at UBC MS Clinic - Information and Support

Post from Dr. Sclafani:

Perhaps it is not appropriate to write a reply, but now that I have been outed as a physician treating CCSVI, I thought I would read what is discussed and see whether anyone would want to hear from someone on the other side of the catheter.

It was clear from reading a few posts that there are great misgivings and lots of unfamiliarity with these tests, their methodology and their use.

This evening I heard some discussions about catheter venography and thought I would try to help sort this out. Catheter venography is the gold standard test for viewing vein anatomy. It is performed under local anesthesia. All the veins connect, so we try to enter in a safe, simple area where the vein is readily available. We would not want to enter in the neck, because it is more difficult to work from there, the vein is very close to the carotid artery and we need to see the entire vein, so putting the tube there would miss part of it.

The leg is the best location up near the groin, because the vein is just an inch or two deep to the skin and readily hit by the small needle that is used. Since we are below the veins involved in CCSVI, the jugular veins and the azygous vein, we must traverse the right atrium of the heart to get to them. Sounds scary but actually that is a relatively easy part of this generally easy procedure. The catheter (tube) we use is very thin, measuring less than a twelfth of an inch in diameter. It is visible on xray so we can find our way. The catheters have different tips with varying curvatures that help get into the veins. Because there are no pain fibers on the inside of the vein, moving the catheter in the veins is painless.

The venogram is always the first part of a treatment of CCSVI. It provides the roadmap for reaching any abnormalities. It makes no sense to divide the procedure into a venogram test followed at another time by the treatment part. They should always be done at the same time. The dye used to see the inside of the veins is a very safe iodine containing substance. Adverse reactions are very uncommon, less common, for example, than many antibiotics or pain medications. I recently reviewed 600,000 exams of which 100,000 had xray dye injected. There were two serious reactions and 17 moderate reactions in the 100,000 exams. I will take those odds.

If I overstepped my bounds, let me know and I will lurk

ciao for now