Pieces of news in the offing: NICE should be publishing their guidance for CCSVI treatment in March, there may be a couple of events coming up in April and May, and follow up news from the ISNVD conference in Orlando.
“It's all about the valves:” PRO (Michael Arata, USA) / CON (Bulent Arslan, USA)
The debate about whether the Valves were at the bottom of every case of CCSVI. Mike Arrata identified four categories of CCSVI:
•Valvular CCSVI most common (good results)
•Restrictive CCSVI patients who don’t have valves (not good results)
•Compressive CCSVI (possible treatment)
•Inflow CCSVI (very rare but untreatable)
He only operated on the cases with valvular problems. When only valvular treatment is carried out there is no need for retreatment.
Arslan Bulent disagreed and said that other problems within the veins could be treated, not all were due to valvular problems. He identified a couple of cases of vein stenoses that could easily and effective be treated.
A vote was taken and Arslan Bulent's argument won the day.
“Is Ultrasound adequate pre-op evaluation for CCSVI?” PRO (Eric Feigenbutz, USA) / CON (Raj Attariwala, CANADA)
They both proffered arguments for their own points of view along the lines of ease of use, validity and cost.
When the vote was taken it came down on the side of the CON, the audience thought that ultrasound on its own was not a good enough diagnostic tool.
After lunch we heard from a Neurologist Jack Burks who throughout the afternoon called CCSVI the treatment not the condition no one drew his attention to this and it kind of summed up the lack of knowledge and understanding that his profession are displaying. During the round table he said that to make any progress with CCSVI (treatment) neurologist and IRs should get together in a room and agree on a protocol and outcomes. We also heard from Dr Dan Simon about the medication best suited to the management of thrombosis.
David Hubbard also spoke of his experience and what the Hubbard Foundation was doing to involve neurologist in the debate, but he had to admit that becoming an advocate for CCSVI had put him into the also ran category.
We next heard from David Williams about Dental Health and Vascular Healing. He described the stupendous improvements of people with MS he had treated for teeth and haw alignment and described the research he had done on the bones of the head and jaw, sleep problems, teeth clenching, and the problems that resulted from these.