Chronic cerebrospinal venous insufficiency or shortened CCSVIis the medical term which describes problems with the blood flow in the centralnervous system veins. As the result of this problem, patients may experience: reducedcatabolite drainage, increased transmural pressure, delayed perfusion, irondeposits around the veins in the brain and intracranial hypoxia. Some scientistssuggest that multiple sclerosis (MS) might also be caused by CCSVI.
Link between CCSVI and Multiple Sclerosis
There are several things Zamboni and his colleagues claimedto connect chronic cerebrospinal venous insufficiency and MS. According totheir opinion, pathophysiology of MS includes stenosis of the azygous and IJVveins in about 90% of MS patients. Further theory explains that these deformedblood vessels can cause accumulation of iron in the brain and consequentlylead to autoimmune reaction of the body. As the result of this autoimmuneresponse, there is degeneration of the myelin sheath of the nerves and that’swhat is causing multiple sclerosis.
There are problems with this hypothesis, because there are alsosome healthy people experiencing CCSVI. Additionally, CCSVI can’t explain allepidemiological facts associated with MS, such as: inheritance, Epstein-Barrinfection, geographical location or the day of birth. Another problem is thatvenous diseases are more common in men, but women are more likely to sufferfrom MS. Venous problems also frequently affect older people (over 50 years of age)and these patients experience hypertension, edema, infarcts or transientischemia. However, MS is usually diagnosed inyounger individuals and these patients don’t experience consequences associated withvenous problems. Also, the accumulation of iron in the brain is usually seen inpatients suffering from Parkinson’s or Alzheimer’s diseases, and these are in no way associated with CCSVI.
For above mentioned reasons, studies can’t completelysupport this theory and there is a need for more epidemiological studies aboutthe relationship between MS and CCSVI.
Zamboni Treatment for MS
Paolo Zamboni is the scientist who started the theory about CCSVI and MS andthe following treatments. He claims that certain endovascular intervention can helppeople suffering from MS. However, there are many reasons why this procedure isnot recommended as standard or safe to be used in MS patients.
Balloon dilation of stenosed jugular veins in patients sufferingfrom multiple sclerosis is the procedure suggested as the treatment for CCSVI,but neither neurological community or various MS organizations worldwide advisethis procedure to their patients or members.
The procedure is not proven to be efficient in controlledrandomized studies. There are also some serious complications that may arise in patientshaving this surgery, including lethal consequences. Patients may experience intracranialbleeding, jugular vein thrombosis or migration of the stent into the heart afterangioplasty and stenting procedures recommended by Zambini. Because of theseproblems, the procedure is banned is some American hospitals and in Canada. Theonly way a patient may have this procedure is when he or she is involved insome clinical trials. In Kuwait the situation is dramatically different andpatients are allowed to have this procedure and it is also paid by their health care system. Some other countries also allow this type of procedure for MSpatients.