What type of improvements can I expect after my liberation treatment?

All the patients we have treated so far have seen improvements ranging from better sensation in thier hands and feet, to increased energy levels,  improved balance, improved cognitive function,  and being able to walk unassisted. Each patient's results are individual, however our clinical experience providing this innovative procedure has shown very positive clinical outcomes.  

Given our positive results, we believe that restoration of the venous blood outflow is removing the fundamental cause of MS namely CCSVI, which is halting MS progression and leading to quality of life improvements for MS patients.

Currently, we are collecting patient case data and clinical results with the aim to publish our findings to further establish the connection between MS and CCSVI and lend additional support for the liberation treatment.

What should I bring to my CCSVI diagnostics and treatment appointment?

Please bring your Magnetic resonance imaging (MRI) records diagnosing your MS, your MS diagnosis and/or a current medical report from your family doctor and/or treating neurologist, and any additional medical history reports you have to help us assess your health status.  

These documents are not mandatory, however when peforming your exams and planning your treatment these documents are very helpful.

How many days should I plan to be in Sofia for my CCSVI diagnosis and treatment?

The hospital stay is planned for three days (two nights), therefore we recommend that you plan to be in Sofia one day before and one day after your hospital stay making a total of 5 days in total.

What steps should I take on the morning of my exam?

Your should have a very light breakfast on the morning of your hospitilzation to be ready for your exams. If you are taking medications please inform us so we can instruct you whether or not to take your medications in the morning before your exams.

Can my friends and family visit with me during my treatment process?

Yes, we allow friends and family to visit those being treated. Our cardiology department, where our CCSVI patients are accomodated during the diagnosis and treatment process, is located on the sixth floor, and we have a hospital hostel the fifth floor for families and friends.

For more information about our hospital hostel please contact our medical tourism partner Diana Nikova of Geya Tours office@geyatours.com.

How long does the liberation procedure take?

The average procedure lasts for 1 hour, and can be longer or shorter depending on the specific medical case. Also, during your procedure we administer local anesthesia and our doctors will communicate with you to walk you through your procedure.

How can I contact my family and friends when I am in Tokuda Hospital Sofia?

We recommend that you bring a laptop so that you can use our wireless internet to contact your family and friends back home. We can also make arrangements to provide an international telephone if you wish.

Will I be precribed any medications after my procedure?

Yes, we will provide you with the neccesary prescriptions. We offer the medications here in our pharmacy for your convenience.


What type of follow up examinations do I need after I return home?

We recommend that your family doctor or treating nuerologist track your MS condition and provide any complementary MS treatment which your physician deems necessary. Our CCSVI center focuses on treating the venous pathology, and we support current other MS treatments and encourage our patient's to seek treatment with a nuerologist to manage thier MS.

Also, we recommend that our CCSVI patients return to Tokuda Hospital Sofia for a comprehensive post procedural out-patient check up exam 6 months after treatment to examine the venous system and collect clinical results. However, if our patients need any assistance or medical advice after the liberation procedure they can directly contact Prof. Grozdinski grozdinski@dir.bg for assistance.

What are your medical practices and standards regarding vein stenting?

Upon confirming venous stenosis in the jugular or aygous vein per our medical protocols and standards,  we perform endovascular balloon dilatation to open the blockage and restore blood flow. 

Only with patient consent and medical indications for cases of resistant stenosis which don't responding to balloon dilatation, we implant stents per our protocol.

What is the difference between balloon dilatation and stenting procedures, and what are their relative risks?

Endovascular balloon dilatation involves inserting and guiding an angioplasty balloon to the location of a stenosis and inflating the balloon to open up narrowed passages in the vascular system to improve and restore blood flow. This procedure has very low risk (nearly zero) and optimal benefits.

However, in some cases balloon dilatation is not enough to keep the viens opens during the endovascular treatment, or with the passage of time the viens can re-stenose or become narrowed once again.  For cases that don't respond to balloon dilatation and only with medical indications and patient consent we can perform venous stent implantation.

The venous stent implantation procedure involves implanting a self-expanding stent into the narrowed vien passage to keep the vessel permenantly open. The procedure is more permanent but has a relatively higher risk than the balloon dilatation procedure because the stent can become blocked by the body's natural clotting process. According to research data, approximately 5% of cases can result in stent blockages. To reduce this risk to a miminum, we prescribe and provide anti-coagulant medication therapy to prevent the blood from clotting in the stent to protect the normal blood flow in the vessel.

What are the risks of the invasive venography and liberation treatment?

The risks of the procedures are near zero, and complications are not to be expected. The invasive venography is a routine procedure involving inserting a catheter into the venous system and injecting a contrast dye under x-ray monitoring control to comprehensively examine the jugular and azygos veins to locate blockages and take measurements of the vascular structures.

The liberation treatment is an endovascular procedure involving inserting a guide wire via a catheter into the venous system to lead angioplastic balloons and/or stents to confirmed jugular and/or azygos blockages to dilate them to improve blood flow and restore normal venous function. The liberation procedure is performed in our 2 high tech angiographic catheterization laboratories which perform approximately twenty similar endovascular procedures per day. We have performed over 100 liberation procedures with out any complications, in fact during the liberation procedure our medical teams talk to our patients under local anesthesia in order to reassure them and guide them through the entire endovascular treatment process.

If you have any questions or suggestions for our FAQ please inform us using the contact form provided below.


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