TVAM (Transvascular Autonomic Modulation) is an endovascular procedure in which a catheter is inserted via a small incision and threaded up into the jugular vein. A balloon is then inflated that stretches the vein. While the balloon is inflated, manual compression is applied over the the balloon. This maximizes the physical energy delivered to the autonomic nerve fibers that travel within the outer tissues of the jugular vein. By stimulating the nerve fibers, we are able to reinvigorate the ANS (autonomic nervous system) by improving communication between the organs and the brain. Patients respond with relief from cognitive impairment (brain fog), chronic fatigue, waking headaches, thermal intolerance, bladder/bowel dysfunction, and other debilitating symptoms of autonomic dysfunction.
The theoretical basis of TVAM arises from the work of Zohara Sternberg. She describes the relationship between CCSVI and autonomic dysfunction. Our clinical experience supports this theory, we believe that the benefits of the treatment may come through stimulation of the ANS during the course of the procedure. The mechanism of action for TVAM is analogous to renal denervation. Renal denervation is also a TVAM procedure, differing in that it involves delivery of thermal energy, while we apply mechanical energy to perivenous autonomic fibers.
Our Medical Facility
The TVAM procedure is performed on an outpatient basis at Synergy Health’s state-of-the-art medical center, located in Newport Beach, California.
Our medical center houses the very latest in diagnostic equipment along with on-site surgical suites and recovery facilities. As a result, the entire treatment process can be handled in-house, from initial testing through the procedure itself.
The Procedure
During the procedure, the patient will receive conscious sedation to maintain comfort throughout, and the treatment will typically take under an hour to perform.
The procedure involves both venographic and intravascular ultrasound (IVUS) evaluation of the jugular, azygos, renal, and spinal veins. Since venous abnormalities are subtle and challenging to identify, during the procedure Dr. Arata uses an IVUS probe 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 a venous abnormality is seen during the procedure, it is corrected by dilation in hopes of providing symptom relief.
Safety Precautions
Synergy Health’s treatment protocols maximize the opportunity for symptom relief while placing the greatest possible emphasis 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. In such cases, stents can be be highly effective in relieving venous compression.
After the Procedure
The majority of patients experience little to no discomfort following their procedure, and they are typically able to resume normal activity within two days.
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 medical center for 48 hours after their procedure. After this 48 period, patients 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 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.
