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Advances in MS Diagnosis: Evidence against CCSVI mounts

In 2009, Dr. Zamboni, a Italian Researcher, introduced the concept of Chronic Cerebrospinal Venous Insufficiency (CCSVI) as a possible cause of Multiple Sclerosis (MS). 1 CCSVI describes reduced blood flow in the veins draining the brain and spinal cord in patients with MS. 2 The proposed treatment – to open these blocked veins through a balloon angioplasty. 2

Dr. Zamboni’s study used a small sample of patients, and lacked some of the rigorous controls that are used in well-designed clinical trials. 2 The results made international headlines and offered MS patients a new-found hope. Some rushed overseas to have the vein-opening surgery performed. The results were controversial.

Since that study, several others have been conducted. But till now the results have been conflicting, and no clear association between CCSVI and MS has been identified.

Doctor Ian Rodger, McMaster professor emeritus and his co-authors, say they found no evidence of abnormalities in head or neck veins of 99 adults with MS compared with 100 healthy controls with no history of any neurological condition (Aug 13th issue of the journal PLOS One). Using Dr. Zamboni’s clinical methodology, the MS patients were randomly chosen from a list of clinic patients until there were 25 for each of the subtypes of the disease. 3

The authors concluded that the case-controlled study “provides compelling evidence against the involvement of CCSVI in multiple sclerosis." 4
In the study, all participants received an ultrasound and MRI of the neck and deep cerebral veins on the same day to ensure their condition didn't change between measurements. Only one MS patient fulfilled Zamboni's ultrasound criteria for CCSVI. The MRIs showed no evidence of narrowing, blockages or vein abnormalities between cases and controls. 3


In a televised interview with the CBC Dr. Rodgers concluded, "The pendulum has swung dramatically away from the idea that CCSVI is a major player in MS." 4

There are a series of ongoing trials looking at CCSVI. Recently the federal government and MS societies in Canada and the U.S. funded a trial of the vein-opening procedure.
Dr. Anthony Traboulsee, Medical Director of the UBC Hospital MS Clinic in Vancouver, is leading a clinical trial to look at whether opening blocked veins in the neck of about 100 patients is safe and effective. Unlike previous studies, Dr. Traboulsee is also using venography with a catheter (instead of ultrasound) to take a detailed look at veins. I a recent interview Dr. Traboulsee stated, “The only way to truly address whether or not this is worthwhile is to do a proper research study. The Canadian study that is underway now will address that." 4

If you have any questions about CCSVI, or vein-opening procedures, please talk to your MS specialist for more information.

Genzyme has no intent to promote or support medical findings, and is only reporting MS-related news and events.

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References:
1. Zamboni P, Galeotti G, Menegatti E, et al. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2009;80:392–9.
2. Multiple Sclerosis and Chronic Cerebrospinal Venous Insufficiency. Information Sheet. College of Physicians and Surgeons of Manitoba. Available at: http://cpsm.mb.ca/cjj39alckF30a/wp-

content/uploads/MS_CC%20Venous%20Insufficiency.pdf Accessed: Aug 16, 2013.
3. Rodger IW, Dilar D, Dwyer J, et al. Evidence against the Involvement of Chronic Cerebrospinal Venous Abnormalities in Multiple Sclerosis. A Case-Control Study. PLOS One 2013;8(8):e72495.
4. CBC News. MS blocked vein theory disputed in Canadian study. Available at: http://www.cbc.ca/news/health/story/2013/08/14/multiple-sclerosis-ccsvi-mcmaster.html. Accessed Aug 16, 2013.

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The point is… We need to stop wasting time and money - resources - on CCSVI - and close the lid on this placebo for once and for all. It’s sad as I know we’re all desperate (I too have MS and am lucky to not be so badly afflicted as others yet) but this is not the answer.


Sep. 05, 2013 / Ckistler 3Thumbs up / 1Thumbs down
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