The Procedure

The Procedure is one element of Synergy Health Concepts’ comprehensive treatment program.

The procedure is performed on an outpatient basis at Synergy Health Concepts' state-of-the-art medical center. Patient Safety is at the forefront of our medical practice. The patient will receive conscious sedation to maintain comfort throughout the procedure and the procedure will typically take under an hour to perform. The primary procedure involves dilating the jugular vein. The majority of patients experience little to no discomfort following their procedure, and they are typically able to assume normal activity within 48 hours.

We have found that symptoms that patients experience are associated with the function of the vagus nerve, which travels alongside the jugular vein. It may in fact be the physical manipulation of the jugular vein that produces the symptomatic changes.

The carotid sheath is a dense fibrous tube delineated by the blue line and contains the jugular vein and vagus nerve.

Distention of the jugular vein could lead to compression of the vagus nerve against the carotid sheath.

Unlike arteries, venous abnormalities are subtle and a challenge to identify. In this respect, venograms alone are inadequate in many cases. Therefore, Dr. Arata uses IVUS, which is attached to the end of the small catheter to create pictures from inside of the veins. This technique increases the accuracy of the overall evaluation of the venous system and allows for more precise measurements of the veins themselves. If an abnormality is seen, it is corrected by dilation in hopes of providing symptom relief.

The procedure involves a diagnostic process with venographic and intravascular ultrasound (IVUS) evaluation of the jugular, azygos, renal, and spinal veins. It also involves dilation of all abnormalities identified during the diagnostic process.

The approach described above maximizes the opportunity for symptom relief with the greatest emphasis placed on patient safety.

Stents are not a typical part of the treatment. In unusual cases, veins that drain the spine such as the azygos may be compressed by external structures. To relieve venous compression, stents have been shown to be highly effective in published studies.

Patients are released from the center after they meet our discharge criteria and are asked to remain in the immediate area of the Synergy Health Concepts medical center for 48 hours after their procedure. After that, they are typically allowed to return to their homes. In an effort to provide optimal safety and comfort we have all patients stay at the Newport Beach Fairmont, which is in close proximity to the Synergy Health Concepts medical center.

*The actual benefits that individual patients experience from treatment can vary from patient to patient. This disparity is based on a number of factors that are often times uncontrollable. While some patients have experienced substantial relief, most patients describe symptom relief of a moderate degree. Others who have undergone treatment have experienced minimal or no relief at all. While we make every effort to provide treatment that will improve symptoms to the greatest degree possible, there is no guarantee that treatment will provide symptom relief.