In order to determine if you are a good candidate for the CCSVI procedure, Dr. Michael Arata and his team of physicians will review your medical history forms. This review will be followed by a phone consultation, during which the specifics of your medical condition will be discussed. Our preliminary evaluation functions as a screening process to ensure patient safety and to identify those patients who are the best candidates for treatment.
It is common to make a diagnosis of CCSVI in patients with Dysautonomia, Multiple Sclerosis, and certain other neurological degenerative diseases including Lyme Disease, Amyotrophic Lateral Sclerosis (ALS), Fibromyalgia, and Chronic Fatigue Syndrome. Patients diagnosed with CCSVI who experience symptoms of Autonomic Dysfunction associated with these diseases often benefit greatly from the CCSVI procedure.
Once a patient arrives at our facility, we perform a comprehensive diagnostic workup to determine whether CCSVI and/or autonomic dysfunction is present. Synergy Health uses the most advanced imaging technology in order to evaluate patients as thoroughly as possible.
A diagnosis of CCSVI (chronic cerebrospinal venous insufficiency) is confirmed when imaging demonstrates abnormal venous blood flow within the jugular and/or azygos veins. The imagining technologies we use in making this diagnosis are Magnetic Resonance Venography (MRV), Duplex Ultrasonography, intravascular ultrasound (IVUS), and Catheter Venography.
Magnetic Resonance Venography (MRV)
Synergy Health is one of the only medical centers where the MRI/MRV diagnostic test is performed on patients prior to their undergoing the CCSVI procedure. Synergy’s Dr. Joseph Hewett is the only interventional radiologist in the world to train directly with Dr. Haacke at his facilities in Detroit.
The MRV allows doctors to observe and quantify flow through the major vessels of the neck and the azygos vein above the heart. This blood flow data along with the 3D structural information are an ideal method for evaluating subjects’ venous outflow. The MRI portion also has the potential to confirm the diagnosis of Multiple Sclerosis or other co-morbidity which may have been previously overlooked. It also may reveal any abnormalities that would place the patient at risk for having the procedure such as an unknown intracranial bleed.
Synergy Health uses ultrasound equipment that has software specifically designed for the diagnosis of CCSVI. Our US technologist received training in Buffalo, New York, specifically on the Zamboni CCSVI protocol.
Duplex Ultrasonography is a form of ultrasound used in CCSVI diagnosis that combines results from Doppler Ultrasound (which visualize blood flow within the vein), with a color-coded data representation (which visualizes venous hemodynamics - especially blood flow direction). This combined process allows highly trained CCSVI diagnosticians and physicians to identify all 5 types of venous obstructions defined in Dr. Zamboni’s technical criteria for CCSVI.
Intravascular Ultrasound (IVUS) is used in the evaluation of every patient. It provides the most detailed images of the veins and valves. The combination of IVUS and venography dramatically increases the precision of the diagnostic evaluation when compared to using venography alone.
A venogram is an X-ray test that takes pictures of blood flow through the veins in a certain area of the body. During a venogram, a special dye (contrast material) is put into your veins so they can be seen clearly on an X-ray picture. A venogram looks at the condition of your veins and the valves in your veins. It also so allows evaluation of flow.
Autonomic Nervous System Testing
Synergy Health’s instrument facilitates the following ANS or Autonomic Nervous System Tests sometimes known as HRV or Heart Rate Variability Testing:
- R-R Variation: (HRV) R-R Variation measures beat-to-beat heart rate variation, as it corresponds to deep respiration.
- The Valsalva: Valsalva test measures beat-to-beat heart rate variation during and following a Valsalva maneuver.
- 30:15 Stand Test: The 30:15 Stand Test measures heart rate variation with the patient’s postural change.
All patients who come to Synergy are tested for autonomic dysfunction, whether or not chronic cerebrospinal venous insufficiency is found to be present. In our experience, patients without venous insufficiency who suffer from autonomic dysfunction still can benefit greatly from the treatment. We believe this is due to the stimulation of the vagus nerve that generally occurs during the CCSVI procedure.