ISNVD Abstract Book

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SUNDAY – FEBRUARY 19, 2012 11:10am-11:30am Summary of the consensus on US imaging standards (Nikolaos Liasis, GREECE) Chronic Cerebrospinal Venous Insufficiency (CCSVI) is characterized by impaired blood outflow from the Central Nervous System (CVS) to the periphery, secondary to anatomical abnormalities of the major neck and azygos veins. The cerebrospinal venous system is usually asymmetric and has a more variable vessel pattern than the arterial system. One of the problems in investigating CCSVI and its potential connection with M.S. is lack of well-established standards for diagnosing CCSVI. Catheter venography (C.V.) is considered to be the for determing the anatomical site, type and extent of lesions producing cerebrospinal venous insufficiency (CCSVI). CV however is an invasive procedure and cannot be used as a screening method. Furthermore it provides little or no data about the vessel wall or intraluminal defects. The most important disadvantages of ultrasound imaging are the artifacts and the subjectivity of the method. To overcome these shortcomings we should use the right ultrasound equipments with proper adjustment of preset – settings. In an effort to ensure high reproducibility and accuracy of the method we suggest a detailed US protocol with standard methodology and five ultrasound criteria. Besides the parameters that might improve the accuracy and reproducibility of the method such as range of velocity, presence and duration of reflux, volume flow in normal individuals and patients with specific lesion of CCSVI, require further research. Combined thranscranial and extracranial Doppler US allows for noninvasive assessment of venous hemodynamic parameters indicative of CCSVI. Finally, it seems that DUS in properly trained hands could become the most reliable and cost effective diagnostic tool for noninvasive screening for CCSVI. Multicenter prospective studies need to be done in combination with DUS, MRV, CV and intravascular US. It is of great importance to elucidate the impact of CCSVI to MS to the medical community as well as to thousands of people in agonized appeal. No financial disclosures to report.
SUNDAY – FEBRUARY 19, 2012 11:30am-11:45am Advancing a CCSVI Research Agenda Focused on Care (Kirsty Duncan, CANADA) Since Zamboni’s initial description of chronic cerebrospinal venous insufficiency (CCSVI), patients, practitioners, scientists, and decision-makers have been left with numerous questions regarding the condition, the procedure, and its impacts on the quality of life for patients diagnosed with multiple sclerosis (MS). In general, questions have focused on the venous system and CCSVI and how these relate to MS, CCSVI diagnosis and treatment, the benefits and adverse effects of CCSVI treatment, re-stenosis and its diagnosis, and secondary procedures. Several questions have received much less attention: namely, combined therapies, follow-up care, supportive care for recovering patients, and prevention in the next generation. In terms of combination therapies, questions should include: "Is CCSVI treatment along with pharmacological agents more efficacious than just the CCSVI procedure? and "Is CCSVI treatment more efficacious with mesenchymal- or adiposederived stem-cell infusion than just the CCSVI procedure alone?" Follow-up care has centered primarily on when re-imaging should be done. However, important questions are: what is the optimal environment for recovery, and what are the best supportive care therapies following the procedure, including, brain plasticity exercises, drugs, nutrition, osteopathy, physiotherapy, speech therapy, supplements, etc., and which therapies have the best outcomes? After treatment, many MS patients want to know how CCSVI can be prevented in the next generation. What would be the best method to discover and treat vascular problems at the earliest time possible to avoid possible health impacts at a later date? Will giving children and adolescents vitamin D reduce the risk of their developing vein inflammation and venous hypertesion? This paper will first present a comprehensive set of questions related to the above issues and recommend a consultative process to develop a research agenda focused on patient care. No financial disclosures to report.
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Page 55 and 56: POSTER ABSTRACTS Monday, February 2
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Page 60 and 61: Background Iron deposition in clini
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Internal jugular vein valve morphol
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The Cerebral Perfusion of Patients
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Intravascular Ultrasound for detect
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Prevalence of Chronic Cerebrospinal
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Azygos compression and effect of re
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Iron deposition in pediatric multip
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Q Q Q Q Simple mathematical model f
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Introduction Cardiac Effects In The
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Acetazolamide as a medical treatmen
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A model of filtration and solute tr
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Physician Documentation of Fluorosc
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Characteristics of patients who mai
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FINDINGS ON VENOGRAPHY IN MS PATIEN
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Does metal-induced hypersensitivity
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GeneralMagneticResonanceImaging(MRI
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Themotivationforthisprotocolofcours
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Magnetic Resonance Imaging (MRI) Tr
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The motivation for this protocol of
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The 2 nd Annual ISNVD Scientific Me
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flow and evidence of increased coll
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Doctors who are using IVUS routinel
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