I have scheduled surgery with Dr. Nakaji at the end of January. I have also been a patient of Constantino and have met with him several times.
I have transverse and sigmoid sinus narrowing on both sides. My non-dominant and 95% occluded vein will be the one Nakaji does surgery on. This is not typical. But it is the side that has the high pressures.
I have read so many stories about people not getting relief after the surgery. I don’t want to borrow trouble! But I want to be prepared and have knowledge.
How is it determined that a stent is needed? It’s to my knowledge that the doctors are hoping the entire vein opens up after the surgery. Constantino has never mentioned anything about stents. Maybe he doesn’t do them?
But I’d like to know at what point in this journey are stents needed?
@Luckee7 - Stents are an absolute last ditch attempt to get a vein to stay open, & we recommend no stone has been unturned to make sure that all possible causes of venous compression have been removed before a vein is stented. Some ppl don’t get the best results from surgery because, in spite of a surgeon’s best effort, some compressor was missed or scar tissue built up during healing. We have a number of members who had IJV decompression done by one of the experienced surgeons on our Doctors List only to find there was still compression somewhere along the vein, so revision surgery was necessary - usually done by a different surgeon.
As you noted, though, there are some cases where the vein won’t stay open after total decompression & ballooning. It’s at that point a stent would be considered as the final step.
I had surgery with Nakaji in October . On the dominant right side.
I have left transverse sinus stenosis that both he and Dr. Mehtha felt could open up after surgery as there is good communication between sinuses.
That can only be determined by another CTV that should not be done until at least 3-6 months after IJV decompression surgery to allow the IJV to open up.
Transverse stent surgery would be Dr. Mehtha as he is vascular radiologist/ surgeon. The sinus stents are not done by Nakaji. Dr. Mehta is very skilled.
I think Luckee is talking about brain stenosis on transverse and sigmoid sinuses as opposed to placing stents in the area of IJV in the neck. Unless I misread this or misunderstood your comment?
I see your point, but replied based on him asking about a stent following IJV decompression so assumed he meant if his IJV didn’t stay open. Since the stent question in @Luckee7 's post was a little ambiguous, we’ve both covered ground he discussed.
