|
|
|
Tuesday, November 23, 2010 8:30 PM
|
Ken Torbert
The experimental nature of CCSVI has been highlighted by several recent news items.
The theory that there is association between narrowing of veins draining blood from the brain was discussed during the recent ECTRIMS meeting in
Sweden. ECTRIMS (European Committee for Treatment and Research in
Multiple Sclerosis) is the largest annual international conference
devoted to basic and clinical research in multiple sclerosis. A
symposium on CCSVI attracted delegates from around the world, including
Paolo Zamboni who proposed the theory, and represented a wide range of
views.
The range of the discussion demonstrated the range of opinions on this subject held by researchers and also the difficulties in addressing a
new area of research. The scientific debate covered fundamental issues
such as the definition and detection of CCSVI, disagreements in the
interpretation of research results and the nature of the association
between CCSVI and MS.
Dr Robert Zivadinov of the University of Buffalo reported on research that showed a higher prevalence of CCSVI amongst people with secondary
progressive as opposed to relapsing remitting MS. He said, "Our findings
point against CCSVI having a primary causative role in the development
of MS. We are showing that CCSVI is connected to the progression of
disease, but whether it is a cause of the progression or a consequence,
we don't know at this time."
The symposium also discussed surgery to correct CCSVI. With some dissenters, the general feeling was that with the current level of
understanding, surgery should only be conducted within the scope of
legitimate clinical studies. Speaking to Medscape Medical News, Dr
Zamboni expressed concerns about treatment being offered outside
research, saying he wants, "a rigorous randomized controlled trial in
order to rapidly understand the value of the angioplasty in MS
treatment, rather [than] perform treatments on patients out of any
scientific and ethical control...It is unethical to charge for an experimental procedure."
These concerns reflect stories in the Canadian press of people experiencing complications from one form of treatment involving the
insertion of stents (small, mesh tubes) to keep affected veins open.
Although generally considered safe, there have been reports of blood
clots forming around the stent and in October one man died in a Costa
Rican clinic following attempts to dissolve the clot.
Discussing the sometimes heated disagreements on the internet and in the popular press about the theory and access to treatment, Dr Zamboni said
"I'm really determined to root this in science, or at least do my
best."
The National Multiple Sclerosis Society in America and the Canadian MS Society have made grants available for research looking into prevalence
and detection of CCSVI and the University of Buffalo is conducting a
trial of vascular surgery.
and another piece of information
Discussion of benefits vs risks of surgical intervention for patients with multiple sclerosis
Paolo Zamboni, MD, professor of surgery at the University of Ferrara (Ferrara, Italy), was among the 430 presenters at the 37th annual VEITH
symposium held at the Hilton New York.
In his November 18th discussion of multiple sclerosis patients who are experiencing decreased blood flow as a result of narrowing of specific
veins of the head and thorax, Dr Zamboni evaluated the risks of surgical
intervention as opposed to the possible rewards. His summary was based
on two recent pilot studies.
Dr Zamboni reported, "Narrowing of the veins in the head and neck has been found to be strongly associated with multiple sclerosis, a
disabling neurodegenerative disease considered to be autoimmune in
nature." As many as 56 to 100 % of MS patients experience narrowing of
the veins of the head, neck or both. Multiple sclerosis is a
neurodegenerative disease, meaning that it is a condition in which cells
of the brain and spinal cord are lost," concluded Zamboni. Dr Zamboni
delivered a comprehensive overview of the actual status of the art of
the diagnosis and treatment of this condition. The condition is
confirmed using high-resolution ultrasound.
In the first pilot study, patients were treated with angioplasty or stenting. Patients with narrowing in the vein in the thorax and those
with narrowing of the vein in the head both showed significantly lower
pressure in their veins after surgery. However, when retested after 18
months, only 53% among those with head vein narrowing had veins that
remained cumulatively unobstructed was, while 96% among those whose neck
veins had been narrowed were without obstruction.
A second pilot study confirmed similar results. Follow-up of the first study revealed a significant reduction of chronic fatigue, one of the
more debilitating symptoms of MS
http://ccsvinews.blogspot.com/2010/11/zamboni-it-is-unethical-to-charge-for.html
|
|