New paper by Fargen, Hui and Hepworth, et al

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Thanks for posting this- a must read for anyone considering stenting!
Such a shame that the benefits don’t seem to be lasting…

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Thank you for the article. It gives “teeth” to the concerns we’ve had about IJV stents. As Dr. Hui said, the procedure shows promise but there’s more work to be done to discover how to make it have complication-free, lasting results.

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It’s so curious, in general, how people with essentially the same symptom profile seemingly due to IJVS have such different outcomes from surgery and procedures. Some get better, some don’t and some get better and then get worse again. I hope they are eventually able to figure out the subtleties that will lead to improved outcomes for everyone.

Dr. Amans gave me this article in our last meeting to support me going ahead with surgery. He felt that it provides data that supports the theory that opening the internal jugular veins in general has a positive impact on symptoms for those with IJVS.

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I wonder if it depends on how long the IJVs have been compressed, whether they re-open properly? I hadn’t had the VES symptoms for that long, so I don’t think the compression was happening for more than 9 months or so…Others have been very unlucky & had symptoms for years before they were diagnosed…

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the_promise,_mystery,_and_perils_of_stenting_for.1084.pdf (532.5 KB)

PDF for easy access

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Just read the paper in detail. Very interesting, seems they dont consider C1 shave unless i am mistaken. They discuss this ‘styloidectomy’ first approach, then move on to stenting. But in the images you can see that C1 tubercle is still compressing the stent. From what i remember it seems that @Barrootz talks about his experience (which is N=1) as having styloidectomy, C1 shave and work on digastric muscle. Maybe its this tackling all these area which gives the best outcomes.

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also, my Dr. (Peter Costantino) was a big proponent of performing a fasciotomy to free up the connective tissues.

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I am still dealing with ‘dizziness’ and it appears to be coming from a hypo-functioning vestibular system. I am being examined closely for SCDS (SemiCircular Canal Dehiscence Syndrome) and, if I do have that…it is likely the result of having high intracranial pressure for all of these years. So, I am speculating that having untreated Vascular Compression might lead to high intracranial pressure, which can cause other issues. Once the outflow is restored…there may be collateral damage to other areas that needs to be addressed too.
I am hoping to know more for myself later this week. Fingers crossed.
Barry

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@Barrootz, What you’ve speculated re: “having untreated Vascular Compression might lead to high intracranial pressure, which can cause other issues.” is absolutely correct. We’ve had several members who were diagnosed w/ SDCS as that was believed to be the result of long-term IIH caused by vascular compression. Apparently the surgery to repair it isn’t too complicated, but as with all surgeries, seeing a surgeon who is experienced will give the best results.

I hope you get a clear answer one way or the other re: SCDS for yourself so you know ho to move forward with treatment.

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