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Dit you know about
the research results of the swedish people
and the Germans mr. van Oosten spoke about?
Because he said on the sheets
its 0% CCSVI in normals and in patients
but as you read the results
of this research
it is extemely interesting
that it was an 150% increase (in jugular bloodflow in upright position)
for the MS patients
compared to the controls.
Thats a huge difference!
And they don't mention it in their title.
Yes, but I would anticipate you
there will be several letters
published in the next issues
of Annals of Neurology
regarding the paper of the German group
And they really ...
this letter, really show that
from a mathematical and physical point of view
the interpretation of the data
was really not satisfactory
and the title is an improper title.
Because with a different methodology
they really confirmed the presence of CCSVI!
And the beautiful thing of this story...
I dont know what will be the end of the story
but the the beautiful thing of this story
is that the MS patients
are very intelligent
very committed
very interested
they really know very well everything
and are also capable
to distingous very well
what is true and probably is not so true :-)
Yes, but nevertheless, mr. Zamboni, this
mr. van Oosten, he at the moment
is now preventing people in the Netherlands
to go for diagnoses and treatment
So they have to go abroad.
This is a sad history of course
but we need to produce
more more more more evidence
to convince other people
to work in this area
The Buffalo results
will be available pretty soon isn't it?
I don't know when.
The good thing that I know
that for example safety
was completely confirmed!
Yes!
So because one of the points
that Liberation procedure
is very very dangerous is not true.
Is not true!
Because we have all this published studies
did not have any huge complications
or important averse effects.
Dr. Marian Simka
has over 600 patients already
never a problem!
I know!
In Germany they have also ...
I know, I know, but ...
this is one of the subjects
used for example in Canada
but also in Italy
by the ministery of health
was used, this very dangerous procedure
so we need to ...
Yes, extremely dangerous :S
Extremely dangerous :( terrible :(
But I understand
with very less evidence
they used a transplantation
with 10% mortality
No problem!
This is not a problem of course.
Not a problem at all yes!
And a procedure with no problems so far
is very dangerous?!
But I am very confident
if we, we should continue work
in this way to produce evidence
we are capable
to change the things really.
What do you think
are the main problems
we have to tackle
in the near future for CCSVI?
Because in your pilot study
you said that a large percentage
of the severe MS patients they ....
they had azygos problems
in the azygos vein.
As far as we know
the clinics in Germany and in Belgium
and maybe also in Poland
they don't find as much azygos problems....
I think that the azygos problem
need to be seen
also from a functional point of view
because it is completely abnormal
if you have reflux
from the superior vena cava
to the left reinal vein
If you put a catheter
in normal people that we have checked
you have immediately, immediately very rarely picture
the hamming into the hart
in this people.
You may probably do not see immediately
stenoses
but you see a reflux which suggest stenosis
if you put high-boost
intravascular ultrasound sonography
you find the defect.
It is very very tiny defect,
nobody uses the projection that I have published
on the outlet of the azygos vein
where you may see the membrane.
Yes, so there is a lot to be done
in that area then?
This is a very important point,
the azygos vein is very very important.
Just one question about the azygos vein,
we saw a small movieclip
about the contrast fluid
which gets into the azygos vein
and we saw a little bit of the fluid
is going towards the spine...
is that a problem?
That is a big problem!
That is a big problem, yes, ok!
Because normally
the blood flows
from the internal vertebral plexus
to the external vertebral plexus
if the azygos is closed
or the left renal vein is closed
for example for external compression.
We found also people with this problem,
the blood is going
from external vertebral to internal vertebral plexus
and create abnormal high pressure
in the spine.
And dr. Salvi, our Neurologist,
found out this is related
for example to a primary-progressive form.
Primary-progressive form
where the laesion is mainly located
in the spinal cord
so there is also a correlation
between patterns of venous circulation
and location of the problem.
So I think that the issue
of the azygos vein
need to be probably shared
among the interventional people
that take care of CCSVI.
And the next appointment could be in Italy
cause we founded an International Society
that is called
'International Society for Neurovascular Disease'.
And we are planning the first meeting
in March in Italy
and we want to establish
some educational session
also about the problem of the Azygos vein.
In order to have
just one protocol for everybody.
This is very important.
So they can not say ...
'we didn’t find anything'
because they didn't use the right protocol.
I had discussion of 'did never find',
'nothing to do here'
and I re-discuss
cases with several interventional radiologists
and now they understand
so there is also an educational aspect
to face and I think this...
Do you think, mr Zamboni,
that being at the start
of discovering everything about CCSVI
that we may have to
well we, you may have
to research a hell of a lot more
before we know
well all about but
fairly all about CCSVI?
There is a lot of research to do! Really.
There is really a lot of research to do!
We have got the collaterals ...
we have got the tiny tiny tiny veins
that can't be ballooned...
What I'll say is that
if you should find
more and more things to research
this is a perfect indicator
1. CCSVI is true!
2. This is very very interesting.
because we probably we do not know exactly
all the good things
that may go out from the research.
So there is a lot to be done!
Yes!
Yes!
Mr. Zamboni, we are so great full
for you granting us this interview
and did you know
this means a lot to the MS patients,
it really does!
So thank you
from the bottom of our hearts!
I thank you very much
for your support
your help
you really are an important part of the story!