Post-operative Process
Posted on 08/26/2011
To minimize bleeding, the incision point at the femoral vein is treated with pressure for 10 to 20 minutes after the procedure, and then covered with a simple dressing. The patient is kept immobile for approximately one hour in order for the incision point to heal. Some physicians will release the patient immediately following this one hour period, while others prefer to keep patients under observation at the hospital for longer periods, potentially overnight.
Follow-up procedures vary by physician, and follow-up visits may be scheduled as early as several weeks post-procedure, or as late as six or more months post-procedure. This variance may reflect the physician’s original intent in performing the procedure. Some physicians are simply interested in treating the blockage; follow-up procedures with these physicians focus primarily on whether the treated area has remained patent (unblocked). Other physicians, however, may be interested in the relationship between CCSVI treatment and MS. Because these physicians may want to measure changes in the patient’s symptom profile and MS disease progression, they may require more frequent follow-up examinations.
Patients often benefit by having their neurologist conduct routine MS disease progression tests (e.g. EDSS) both before and after CCSVI treatment. This provides the patient and the patient's neurologist with clear before versus after measures of the impact of the CCSVI treatment. Such information may be useful in determining the best post-treatment program for the patient. Further, this information provides a formal record of CCSVI treatment impact, which may help advance our understanding of CCSVI. Note that patients may benefit from these before and after tests regardless of whether the neurologist supported the decision to have CCSVI treatment, and regardless of whether their CCSVI physician will be conducting his/her own follow-up tests.
Following an endovascular procedure, the patient is typically placed on anticoagulant or anti-platelet drugs to prevent blood clotting. (In balloon angioplasty, the inflated balloon may cause trauma to the vein, potentially exposing the muscle layer to blood, which can cause clotting; with stents, clotting may occur when blood flow is disrupted or caught in the struts or mesh of the stent.) Depending on the physician’s preference, this course may run for days or for a couple of months, and may use any of a variety of commonly prescribed and over the counter medications such as Plavix, Arixtra, aspirin, Coumadin, or others. When taking anti-coagulants or blood thinners (e.g., Coumadin), blood samples must be checked regularly to insure that the level of drug effectiveness is within a desired range that limits the risk of bleeding complications. This typically involves a common blood draw from the arm or a finger prick. Outpatient clinics and medical centers may perform this function, and a revisit with the primary doctor is generally not necessary. Blood checks are not necessary for those patients taking anti-platelet agents (e.g., Plavix, aspirin, etc.) exclusively.
Lastly, while the basic endovascular procedures used in CCSVI treatment are commonplace, they still expose patients to certain types of risk. For details, please read our Treatment Risks page.
