CCSVI Liberation treatment and Multiple Sclerosis
CCSVI occurs in only about 30% of MS patients. Chronic cerebro-spinal venous insufficiency (CCSVI) is a syndrome in which the flow of blood in the cervical and thoracic veins, from the central nervous system (CNS) to the heart, is compromised and less efficient. It is proposed that insufficient venous blood flow, in turn, promotes development of brain dysfunction, especially multiple sclerosis.
The reported blood flow compromises involve both reduced and intermittently reversed flow velocities in the cerebral veins, changed brain capillary dynamics (altering the blood-brain barrier), and are reportedly associated with stenosis of the jugular and azygos veins. Paolo Zamboni in 2008 reported an association of CCSVI with multiple sclerosis (MS). The hypothesis has generated optimism, especially from patients, for more effective treatment options for multiple sclerosis.
Symptoms and consequences
Potential consequences of the syndrome could be hypoxia, delayed perfusion, reduced drainage of the catabolites and increased transmural pressure, and iron deposits around the cerebral veins.
Pathophysiology, Diagnosis and Treatment
MS patients diagnosed with CCSVI undergo catheterization of the azygous and IJV veins and such veins are stenosed in around 90% of the cases. Malformed blood vessels caused increased deposition of iron in the brain, which in turn triggers autoimmunity and degeneration of the nerve’s myelin sheath. Nevertheless iron deposition occurs in different neurological diseases such as Alzheimer’s disease or Parkinson’s disease but CCSVI was not seen in their control group with neurological problems.
CCSVI was first found combining extracranial and transcranial doppler sonography. Five parameters of venous drainage have been proposed to be characteristic of the syndrome, although having two of them is enough for diagnosis of CCSVI. They are: reflux in the internal jugular and vertebral veins, reflux in the deep cerebral veins, high-resolution B-mode evidence of stenosis of the internal jugular, flow in the internal jugular or vertebral veins that could not be detected with Doppler, and reverted postural control of the main cerebral venous outflow pathways.
Use of Magnetic resonance venography for the diagnosis of CCSVI in MS patients has limited value, and has been proposed to be used only in combination with other techniques. Balloon angioplasty has been used to treat MS patients who had been diagnosed of CCSVI and had their cerebral veins stenosed. These surgeries have clinical benefit, especially in those patients with the relapsing-remitting subtype.
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