What is CCSVI
In 2009, Italian researchers, led by Dr Paolo Zamboni, discovered that, in many persons with multiple sclerosis, the veins which act as the main drainage pathways for blood flowing from the brain are substantially narrowed and even blocked. These include the jugular veins, veins along the spinal column, and other veins such as the azygous vein. They labeled this compromised venous drainage as “chronic cerebrospinal venous insufficiency” or CCSVI.
The researchers also documented that impaired venous drainage from the brain caused venous blood to flow back into the brain which resulted in iron
deposition and inflammation of the blood-brain barrier (BBB). A compromised BBB has long been known to be part of the MS disease process. On the basis of these findings, the researchers reasonably concluded that CCSVI was quite possibly a causal factor of MS and that the restoration of proper blood flow from the brain may well be of significant therapeutic value.
Can CCSVI be treated?
The Italian researchers developed a treatment to relieve the venous drainage problems. The problematic veins are first identified by venography. Then, balloon angioplasty is used to open up the problematic veins. The procedure is relatively non-invasive and is done in day hospital under local anesthesia. Unfortunately, it was found that, for many patients, the impaired venous drainage returned within a few months. At this time, an effective treatment which resolves and maintains proper flow for all patients has not yet been developed.
Is CCSVI Treatment of value?
The critical question of the benefit of restoring proper blood flow for persons with MS has not been answered. A few small trials have been performed but the results did not answer the question of benefit because many of the treated persons did not have proper blood flow established for very long. Notably, there are many well documented accounts of persons with MS experiencing major benefits once their blood flow was restored and maintained.
Further clinical research on CCSVI resolution is required using techniques that both restore and maintain proper blood flow from the brain. Unfortunately, non-drug treatments for MS, such as CCSVI resolution, have always been marginalized by the medical-pharmaceutic complex, mainly for financial reasons. Undoubtedly it will be a very long, hard fight to get the necessary clinical research done given the strong opposition to such research by the financially-compromised neurological community.
Is it worth testing for and possibly treating CCSVI?
Given the likely lack of proper research in the foreseeable future, persons with MS are faced with the question of “should they have their venous drainage from the brain evaluated and treated if found to be impaired?”. There is no easy answer to this obvious dilemma which is being forced on PwMS due to the current lack of a patient-centred approach to MS research.
Abundant empirical data demonstrate that most persons with MS have impaired venous drainage from the brain. Furthermore, there are solid, theoretical arguments that impaired venous drainage contributes to the MS disease process. Given the above, it is likely restoration and maintenance of proper venous drainage is of some value. The main problem is the maintenance of proper flow over the long term and currently there is no procedure which has a high likelihood of achieving this. Thus, having venous angioplasty to resolve CCSVI is a gamble as the current data indicate 50% or less of those having the procedure will have proper blood flow restored and maintained over the long term.