Introduction
Multiple sclerosis (MS) is a chronic neurological disorder that affects the central nervous system (brain and spinal cord). The
hypothesis of a chronic cerebrospinal venous insufficiency was already developed a hundred years ago and recently reinvented
by Dr. Paolo Zamboni. He described that in patients with MS a narrowing of the jugular vein (the vein, transporting the
blood from the brain to the heart) is frequently seen. He also observed valve abnormalities of the vein resulting in a reflux (the
valve is not functioning and blood is flowing back into the brain). As a result iron is deposited in the brain and causing an inflammatory
reaction. (These are the so-called white plaques, visible in the MRI)
This would indicate that MS, at least in part can be explained as a venous disorder. Of course MS is a multi factorial disease and
CCSVI might be just one aspect.Treatment with angioplasty seems to be a promising therapy to improve the condition of MS patients with CCSVI1-3.
Methods
Patients with MS were treated with angioplasty.
X-ray scanning was used to guide
a balloon-tipped catheter into the
affected jugular vein(s). Once the catheter
reached the target area, the balloon tip
expanded to widen the stenotic area. The
treating physician examined each
patient's condition on the first and second
treatment day.
Results
From the number of patients (N=42) that
were examined twice, 86% improved after
the first angioplasty. No change was
reported in only 6 patients. None of the
patients deteriorated after liberation angioplasty.
The most frequently observed
improvements in patients during their
second examination were more energy
(26,2%), improved walking (21,4%),
improved speech (19,1%), and reduced
spasms (16,7%). All improvements were
observed by their treating physician.
Conclusions
In summary, angioplasty has shown to have
a strong positive effect on the condition on
treated MS patients. Venous angioplasty
appears to be a safe and potentially powerful
therapy MS patients with CCSVI. Controlled,
double-blind, randomized clinical
trials should be perfromed to determine if
venous angioplasty treatment is superior to
placebo in MS patients with CCSVI"
References
1 Zivadinov R, Schirda C, Dwyer MG, Haacke ME, Weinstock-
Guttman B, Menegatti E, Heininen-Brown M, Magnano C,
Malagoni AM, Wack DS, Hojnacki D, Kennedy C, Carl E, Bergsland
N, Hussein S, Poloni G, Bartolomei I, Salvi F, Zamboni P.
Chronic cerebrospinal venous insufficiency and iron deposition
on susceptibility-weighted imaging in patients with multiple
sclerosis: a pilot case-control study. Int Angiol. 2010
Apr;29(2):158-75.
2 Paolo Zamboni, MD, Roberto Galeotti, MD, Erica Menegatti,
RVT, Anna Maria Malagoni, MD, Sergio Gianesini, MD, Ilaria
Bartolomei, MD, Francesco Mascoli, MD, and Fabrizio Salvi, MD. A
prospective open-label study of endovascular treatment of
chronic cerebrospinal venous insufficiency. December 2009.
Journal of Vascular Surgery. Volume 50, Issue 6 , Pages 1348-
1358.e3
3 Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Tacconi G,
Dall'Ara S, Bartolomei I, Salvi F. J Neurol Neurosurg Psychiatry.
Chronic cerebrospinal venous insufficiency in patients with
multiple sclerosis. 2009 Apr;80(4):392-9.
For more information see: http://www.xcell-center.com/media/218768/ccsvi_result_eng.pdf