CCSVI and Multiple Sclerosis; Does Surgery Improve MS outcome?

Abstract

Background: Studies conducted by Zamboni et al. have suggested a new hypothesis that an abnormal drainage of venous blood due to stenosis or malformation of the internal jugular and/or azygous veins can be the cause of MS. They called this abnormality as “chronic cerebro-spinal venous insufficiency (CCSVI) could result in increased permeability of blood brain barrier, local iron deposition and secondary multifocal inflammation. In this presentation, we will discuss the more relevant scientific data related to this issue.

Materials and Methods: Balloon angioplasty in a preliminary study by Zamboni improved symptoms in MS. High re-stenosing rates led authors to propose that the use of stents might be a better treatment than balloon angioplasty, although later they stated that stents should not be used. Balloon angioplasty and stenting have been proposed as treatment options for CCSVI in MS.

Results: Many patients who have had the surgical procedure report their improvements on social media websites such as structured patient databases and YouTube. Such stories are only anecdotal evidence of efficacy, and do not constitute a scientific proof of the efficacy of the treatment since for example, those who have had a positive result are more prone to post their cases than those who had little or no improvement, and the reported improvements in patients' condition can be attributed to the placebo effect.

Conclusion: Because there is a lack of research evidence to suggest that this is a safe or effective treatment for people with MS, we do not recommend that people undergo this procedure outside of a properly-regulated clinical trial.