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The field of vascular research is growing at a tremendous rate.
In the past 10 years studies have been performed to improve the way we treat numerous vascular conditions, like abdominal and thoracic aneurysms, carotid artery disease, peripheral arterial disease, claudication and vascular bypass surgery. Vascular Research studies using drug therapy, surgical devices, stem cells and gene therapy are underway today. At the present time we have new less invasive techniques to treat many of vascular conditions which have improved patient survival rates, cut done on hospital stays and returned patients back to the work force in record time essentially saving lives and money.
Medical research is the study of a disease or medical condition with the goal of coming up with a new way to treat the condition and improve patient care.
Before a pharmaceutical company can start a clinical research study on humans they must conduct pre-clinical or laboratory research. After many years of successful research on cells and research animals the pharmaceutical company takes the data to the FDA, Food and Drug Administration, to request approval to begin human testing; research. There are usually 3-4 phases of testing in humans before the pharmaceutical company requests approval from the FDA to market the drug or device.
Every device, medicine and treatment used in vascular medicine today has gone through a clinical trial before being FDA approved.
There are many vascular research trials going on right now.
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CCSVI
Multiple Sclerosis (MS) has long been recognized as a disorder affecting the spinal cord and the brain (the central nervous system). The causes leading to MS remain poorly defined and patients with Multiple Sclerosis have neurological symptoms that are often progressive. Currently there is no known cure for MS. The treatment is focused on limiting MS attacks to prevent further disability. The diagnosis of MS is focused on clinical, laboratory, and radiologic data supported by a method used by practicing neurologists.
Recently there has been a possible association made between MS and chronic cerebrospinal venous insufficiency (CCSVI). CCSVI occurs when the flow of blood in the veins of the chest and neck is compromised. This causes less efficient draining of blood from the brain. It is proposed that insufficient venous blood flow, in turn, promotes development of brain dysfunction, especially in MS.
Diagnostic Testing
Duplex ultrasound
This is a non-invasive test which uses ultrasound to send high frequency sound waves which reflects from moving red blood cells. This is done by placing a probe over your chest and neck. Ultrasound gel is placed on the skin underneath the probe to help see the vessel better. This test takes approximately 45 minutes.
This test allows the doctor to evaluate the blood flow in the veins of your neck and determine the options for treatment. These tests are routine in the evaluation of patients with blood flow disturbances in the vein.
Expanded Disability Status Scale (EDSS)
The EDSS is a disability status scale to evaluate patients with MS. The EDSS ranges from 0 - 10 with higher scores indicating more severe disability. At each visit the scale will be done with you to determine a score.
Unassisted Timed 25 Feet Walk
This is a test that will be used to assess leg and ambulation function if a patient is capable of walking. This will be done at all visits. You will be asked to walk 25 feet as quickly as possible. This will be done twice and the average time will be taken.
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Venogram
Before the procedure begins, an IV catheter (narrow tube) will be placed for injecting fluids and medication during the procedure. The diagnostic test typically takes less than one hour. During that time, the doctor will make a small puncture in your groin and a catheter (narrow tube) will be inserted and advanced up into the veins in your neck (internal jugular or azygous). Dye is injected into the vein and several x-rays are taken. This test will allow the doctor to determine if you have blockage in your veins. If CCSVI is confirmed, the doctor may proceed to Venoplasty.
Minimal Invasive Treatment- Venoplasty:
Treatment for CCSVI is an endovascular procedure to dilate the narrowed vein(s) with a balloon (venoplasty). This procedure is done in conjunction with the diagnostic venogram (see above). It is thought that this procedure may reduce symptoms in MS patients that are diagnosed with CCSVI.
This procedure takes less than an hour to complete. After the procedure is complete, you will be taken to the interventional recovery area. Pressure may be applied to your groin where the catheter was removed and replaced with a bandage. You will be on bed rest for up to 2 hours. You will be sent home the same day and discharge instructions will be given to you.
Medical Treatment
All patients are advised to maintain their current medications.
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Vital Vascular Statistics
- Over 45,000 people die from aortic disease each year.
- Over 12 million people have peripheral vascular disease.
- Obesity leads to diabetes, heart and vascular disease.
- Over 60 million people in the United States are over weight.
- Over 70,000 leg amputations are preformed each year.
- Over 25 million American's are at risk for vascular disease
- If you have PAD it is approximately 5 times more likely that you will die from heart disease
- Over 700,000 people have strokes each year
- Carotid Artery Stenosis and stroke are the leading cause of loss of independence for people.
- 80 million adults in the United States have varicose veins of the legs.
- Over 15,000 Americans die because of ruptured aneurysms.
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