Chronic cerebrospinal venous insufficiency (CCSVI), or the pathological restriction of venous vessel discharge from the CNS has been proposed by Zamboni, et al, as having a correlative relationship to Multiple Sclerosis. From a clinical perspective, it has been demonstrated that the narrowed jugular veins in an MS patient, once widened, do affect the presenting symptoms of MS and the overall health of the patient. It has also been noted that these same veins once treated, restenose after a time in the majority of cases. Why the veins restenose is speculative. One insight, developed through practical observation, suggests that there are gaps in the therapy protocol as it is currently practiced. In general, CCSVI therapy has focused on directly treating the venous system and the stenosed veins. Several other factors that would naturally affect vein recovery have received much less consideration. As to treatment for CCSVI, it should be noted that no meaningful aftercare protocol based on evidence has been considered by the main proponents of the ‘liberation’ therapy (neck venoplasty). In fact, in all of the clinics or hospitals examined for this study, patients weren’t required to stay in the clinical setting any longer than a few hours post-procedure in most cases. Even though it has been observed to be therapeutically useful by some of the main early practitioners of the ‘liberation’ therapy, follow-up, supportive care for recovering patients post-operatively has not seriously been considered to be part of the treatment protocol. To date, follow-up care has primarily centered on when vein re-imaging should be done post-venoplasty. The fact is, by that time, most patients have restenosed (or partially restenosed) and the follow-up Doppler testing is simply detecting restenosis and retrograde flow in veins that are very much deteriorated due to scarring left by the initial procedure. This article discusses a variable approach as to a combination of safe and effective interventional therapies that have been observed to result in enduring venous drainage of the CNS to offset the destructive effects of inflammation and neurodegeneration, and to regenerate disease damaged tissue.
As stated, it has been observed that a number of presenting symptoms of MS almost completely vanish as soon as the jugulars are widened and the flows equalize in most MS patients. Where a small number of MS patients have received no immediate benefit from the ‘liberation’ procedure, flows in subject samples have been shown not to have equalized post-procedure in these patients and therefore even a very small retrograde blood flow back to the CNS can offset the therapeutic benefits. Furthermore once the obstructed veins are further examined for hemodynamic obstruction and widened at the point of occlusion in those patients to allow full drainage, the presenting symptoms of MS retreat. This noted observation along with the large number of MS patients who have CCSVI establish a clear association of vein disease with MS, although it is clearly not the disease ‘trigger’.For more information please visit ccsviclinic.ca/?p=978
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leovoisey
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I am unclear about the reasons for this post, and feel I should point out a couple of things that casual readers of AMN Easier may wish to reflect on.
First, the article and the web site from which it is extracted relate to experimental therapies for MS (Multiple Sclerosis). But AMN is not MS, even though some of its disease characteristics (such as myelin damage) and its clinical presentation have similarities to MS. So the approaches that the article describes do not necessarily have any relationship to AMN.
The second point to make is that the article and Web site relate to very novel procedures for treating MS. From what I can glean from the site, these combine two strategies that are claimed to alleviate MS symptoms. The first is the so-called “liberation” therapy, a technique for widening the otherwise narrowed jugular veins of MS patients. The second is stem cell therapy, whereby stem-cells are injected sometime after the “liberation” therapy.
Regarding the first of these, the procedure is based on a theory that MS is caused by these narrowed jugular veins and is not (as is otherwise believed) an auto-immune disease. The condition is described as “chronic cerebrospinal venous insufficiency” (CCSVI). The web site to which this post is extracted – ccsviclinic.ca - appears to be a Canadian clinic with a hospital in Pune, India, that specialises in the “liberation” therapy. The scientist that proposed the theory, Dr Zamboni, conducted only one small, uncontrolled study that indicated that one specific vein-widening procedure can alleviate symptoms for one specific type of MS sufferer. (He never claimed more than that apparently). Despite this, the procedure has been taken up, notably in Canada, where desperate MS patients have paid many dollars to travel to India and other places for the treatment. One patient has died in Costa Rica. Despite claims, there have been no measurable benefits to patients.
On the second aspect of the treatment described – stem cell therapy – there is clearly much going on world wide on this. But any possible stem-cell therapies that could assist AMN have not yet been devised or tested so far as I know.
None of my comments should infer that the CCSVI techniques described might one day be proven to be beneficial to MS patients. It’s just that the trials and evidence on which MS patients could rely is not in, and may never be. But it was ever thus for controversial treatments – in summary, you need to do your own investigations, talk to more than one expert, and be very aware of the risks involved.
Progress in medicine and science almost always starts with a theory, but this needs to be researched, tested and proven.
I ask anyone who chooses to post articles like the above to at least make sure that they say why they think it is useful for AMN patients, and to provide some commentary on some of the other evidence that may be out there. As administrator of the site, I must ensure that patients looking for ways of dealing with AMN are not misled.
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