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665881 tn?1248930597

CCSVI – A Huge Breakthrough in MS

PART 1:

HELLO PEOPLE! I posted something similar the other day, but i feel like this is a WAY better article!
I'm so excited about this and think this just might be one of the final peices to the MS puzzle!!!
Hope you enjoy!
xx

This is a Dr or someone writting this
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CCSVI – A Huge Breakthrough in MS
Last modified: 09.02.2010 - 22:51 CET Created: 03.11.2009 - simplex
Written by Ashton Embry PhD for New Pathways Magazine. Nº 57. September/October 2009

In August, I received a message asking me what I thought about CCSVI in multiple sclerosis. I had the same reaction most of you did when you read the title of this article – “What the hell is CCSVI?” A Google search told me it stood for “chronic cerebrospinal venous insufficiency” and a PubMed search led me to a handful of papers on CCSVI, all authored by an Italian vascular researcher/surgeon named Paolo Zamboni.

The papers provided solid and mind-expanding evidence that an entirely new disease process was part of MS. It soon became clear that the concept of CCVSI had the potential to completely change how we saw MS and how to treat it.

The Italian researchers discovered that, in persons with multiple sclerosis, the veins which acted as the main drainage pathways for blood flowing from the brain back to the heart were substantially narrowed and even blocked. These included the jugular veins, veins along the spinal column, and other veins I had not heard of before such as the azygous vein.

The researchers had never seen these problems in anyone before. Their equipment allowed them to study the blood flow in the veins and to also take pictures of the veins. They found that all the persons with MS they examined had impaired venous drainage from the brain and that such a problem caused the phenomenon of “reflux”. This means the venous blood would flow back toward the brain as it established new pathways around the blocked and narrowed veins. They labeled this compromised venous drainage as CCSVI.

Improper venous drainage is well known in the lower torso of many people (e.g. varicose veins, etc). In some cases, it has been demonstrated that poor venous flow in the lower body can result in iron deposition and associated inflammation. Furthermore, sclerosis and degenerative lesions can occur with the inflammation.

Knowing the problems that poor venous drainage can cause in the lower torso, Zamboni and his co-authors offered the reasonable interpretation that the reflux action of the blood flow into the veins of the brain resulted in iron deposition and inflammation of the blood-brain barrier (BBB). Notably iron deposits have long been documented in MS lesions and it is well known that every MS lesion forms symmetrically around a vein. Such characteristics of MS lesions have never been satisfactorily explained before the Zamboni discoveries.

In the MS literature, there are two opposing hypotheses for how MS autoimmunity begins. The most popular one is that myelin-sensitive T cells are activated through molecular mimicry by a childhood virus such as EBV. The myelin-sensitive T cells then cross the BBB and lead an autoimmune attack on myelin.

The other hypothesis is that the initial event in the MS disease process is a breech of the BBB and the consequent exposure of the central nervous system to the immune system. This uncovering of previously hidden antigens not seen before by the immune system leads to an autoimmune attack on myelin.

With the work of Dr Zamboni, it now appears that the second hypothesis, the breech of the BBB due to impaired venous drainage, is the best explanation for the initiation of MS autoimmunity. In support of this, the researchers found that, of the 109 persons with MS studied, every last one of them had impaired venous drainage. Furthermore, of the 177 control subjects, a group that included persons with other neurological diseases and healthy people of various ages, not a single one had impaired venous drainage from the brain. Such a 100% separation of persons with MS from controls on the basis of impaired venous drainage leaves little doubt that such a phenomenon is very important in the MS disease process.

Another important observation made by Zamboni's team is that the pattern of reflux, that is, the specific pathway the blood uses to flow back to the brain, showed a strong correlation to the type of MS. Persons with PPMS had a different reflux pattern that those with RRMS and SPMS. Furthermore, the PPMS reflux pattern provided a good explanation why this form of MS is more aggressive and problematic.

The other convincing data that demonstrates that CCSVI is a key part of MS are the results from the use of a treatment which relieves the venous drainage problems. This treatment is called „the liberation procedure”. The problematic veins are first identified by venography. Then, balloon angioplasty is used to open up the problematic veins and, in some cases, stents are inserted in non- responding sections. The procedure is relatively non-invasive and is done in day hospital under local anesthesia. Access to the veins is through the left femoral vein in the thigh. Total time in the hospital is usually less than 6 hours and the subject has a compression dressing on for 24 hours.

Dr Zamboni has described the results of the use of the liberation procedure on 51 patients with relapsing-remitting MS. Eighteen of the subjects were treated in emergency with an acute attack and all of them had their symptoms completely resolved within a few hours to a few days. The other subjects had a greatly reduced yearly attack rate and, notably, the only ones experiencing an attack following the procedure were those who had a recurrence of the impaired venous drainage problems. The subjects also reported a dramatic improvement in chronic fatigue. In summary, it would appear that the relief of venous drainage problems results in major improvements of MS symptoms. This is further evidence of the major role that CCSVI plays in MS.

Finally the researchers noted that there was no difference in the severity of venous drainage problems between those using an MS drug and those not on a drug.



Last modified: 09.02.2010 - 22:51 CET Created: 03.11.2009 - simplex
Written by Ashton Embry PhD for New Pathways Magazine. Nº 57. September/October 2009
http://csvi-ms.net/en/content/ccsvi-huge-breakthrough-ms
42 Responses
665881 tn?1248930597
PART 2:


Given that CCSVI explains why PPMS differs from RRMS, as well as the occurrence of previously inexplicable features of MS lesions (e.g. venocentricity, iron deposits), CCSVI becomes a very compelling explanation for the initiation of CNS autoimmunity which drives MS. Further research is needed to confirm this.

Perhaps the most important question that remains is “what is the ultimate cause of the venous drainage problems?” Zamboni and colleagues did not offer any explanations/speculations on this. Hopefully, this question will be the subject of an intensive research effort. It is worth noting that, given adequate vitamin D in childhood prevents MS in most cases, vitamin D supply must have a substantial effect on the venous drainage system.

This new understanding of the MS disease process makes the use of the recommended nutritional strategies even more imperative. These strategies enhance blood flow, strengthen the BBB, counteract autoimmune reactions and quite possibly improve venous drainage from the brain. Overall, the Zamboni work provides further insight into why nutritional strategies work so well for many people.

In answer to the question in the title of this article, I am convinced that CCSVI is a huge breakthrough for MS. Correction of this problem with a relatively simple procedure may well turn out to be a very effective, long lasting, drug- free treatment for MS at the time of diagnosis. However, a great deal of research and clinical testing will have to happen before CCSVI is widely accepted as a key part of MS and the liberation procedure becomes standard procedure. In the past, non-drug treatments for MS have been marginalized, mainly for financial reasons. I predict it will be a long, hard fight to get the treatment of CCSVI from the laboratory to the clinic.
572651 tn?1531002957
It is so tempting to be excited, but the evidence if far from convincing. There is still a lot of work to be done in this field.  And if I understand this correctly, even Dr. Zamboni himself is not making claims that CCSVI is the CURE for MS.  

I also think I read that his wife, even though she has improved since the procedure, is still taking her DMD as prescribed.

The author of the article you quote is well known for his diet and nutrition cure of MS, which according to his reports is what cured his son.  He steps into the larger unknown with his thoughts here - they are largely unsubstantiated.  Just one example " given adequate vitamin D in childhood prevents MS in most cases, vitamin D supply must have a substantial effect on the venous drainage system."  What does he base this on?  We know there MIGHT be a link between D and MS, but that has been studied intensively and still not proven.

As for the conspiracy theory - as much as I know the dark side of human nature, I absolutely refuse to believe that a cure for MS is being blocked by pharmaceutical companies that arer more worried about their profits.

It looks like CCSVI plays into the larger MS picture, somehow.  How it fits, though is still a big question.   In the meantime while this is all playing out, everyone should stay the course with the treatment they are on.  The DMDs are our best proven treatment as of now.

be well,
Lulu




338416 tn?1420049302
I think they've done further research on the impaired venous reflux phenomenon, and found it wasn't a 100% division between MS patients and controls.  Some MS patients do not have blocked neck veins.  This isn't to say that that's not a factor, just that it looks like there's more to it than just CCSVI.
147426 tn?1317269232
CCSVI is still in the hypothesis stage.  That means, they don't know how much or why but are tantalized into putting forth theories.  This has NOT by any mean been shown to be a cure of any sort.  In fact, the "treatments" they have tried have not lasted long, per Dr. Zamboni's own reports.

The much larger study out of Buffalo did NOT in any way support Zamoboni's finding that 100% of MSers suffer from CCSVI.  Indeed, they found only 55% had such stricture or venous insufficiency and that it was found in 25% of controls.  This is a FAR cry from 100% and 0%.  55% is hardly even very exciting, in my mind.  Claiming that those 55% might have been misdiagnosed is silly.  As I understood it, the researchers in Buffalo reviewed the patient's file to see that they were likely to have MS as their correct diagnosis.  Overall, looking at MS Clinics across the country, the incidence of misdiagnosis is about 10%.  The additional review of the patient's files would have likely lowered the chance of misdiagnosis.

It is far too early to be jumping on this as the answer to the problem of effective treatment for MS.  Our current knowledge of the treatment for CCSVI shows a couple things.  Use of balloon angioplasty appears to lose its effectiveness within months in a large number of people.  This is a highly invasive procedure and not one you would want to have regularly.

The use of a stent is not at all ready for prime time.  At Stanford the stents were associated with some unacceptable side effects, including one instance of the migration of the stent into the heart which necessitated immediate open heart surgery.  Veins are highly stretchable compared to arteries.  They swell and contract depending on the volume of blood at any one time.  Doctors cannot just transfer the technology of arterial stents to the veins.

I also do not believe that there is any conspiracy at play here, nor is there likely to be.  The claim that the medical profession with or without the help of Big Pharma has hidden the truth of cures for disease from the public is an old one dating back half a century.

I think the whole topic is being overblown by careless science media who fail to report the whole story and being picked up and prematurely "hailed" by desperate people hoping for a cure.  .  We are pretty far (years) from showing 1) that CCSVI is truly a major player in MS, 2) what role it plays, causative or resultant, 3) that relief of the problem can truly affect the course of the disease, 4) knowing what treatments are most effective and most safe, 5) knowing how long those treatments will have a lasting effect, 6) Knowing how to screen for the problem and 7) knowing if the problem can be prevented by any means.

Zamboni's studies were quite flawed and I doubt that their results will be replicated when the science method is applied rigorously.  Still it needs to be done - and as quickly as possible.  That is how we find out stuff and separate the real stuff from the promising, but otherwise unhelpful things.

I am not a nay-sayer, just very doubtful about all of this.  As I said in my journal, some months ago, there are a lot of things we DO know about MS and my mind cannot put CCSVI into line with those things.  I now add onto that doubt the underwhelming results by the group in Buffalo, despite their premature and overly excited press release the day before the intial finding were revealed.

I do not see that CCSVI is a huge breakthrough.....yet.  It's just too early.  

This is just my view of the issue.

Quix
147426 tn?1317269232
We should note that this article was published February 2, of this year, before the less impressive results of the Buffalo group were released.  Zamboni's 100% and 0% were not replicated - at all.

Q
704043 tn?1298060444
well  i  sure  hope  they  fine tune it  and  its  the  cure!!  but.....
   i  read  the  other day  something  about  oxygen- they  put you in a  tube  and  decompress you  - and  there  was  some excitement  about it-  being  good
for  us the oxygen  helps  with  our cells- blood   everything!   but  we'l  see
     tick
667078 tn?1316004535
I for one am not signing up for this cure. Nor eating 7 roundworms.

Alex
147426 tn?1317269232
Aw, come on, Alex, just try two.

Quix
Avatar universal
My brother is having this procedure done this week in Philadelphia if he qualifies ( it will help him possibly) I will let you know how it goes- wish him luck!
572651 tn?1531002957
Hi Healthnut - I see you have posted a separate thread so I will respond to this over there rather than add on to this one.
665881 tn?1248930597
Hi, thanks for your post! I will be looking forward to hearing his results in the future. Best of luck to him and i hope it will be a future cure. Thanks...oh and p.s  can you come back to this post to let me know the results as i don't really look on the forum all that much :)

xx Sammy.
562511 tn?1285907760
It is interesting reading articles that is written about CCSVI by different authors.  Each has their own interpretation.  That is why I appreciate the internet.  We can draw our own conclusions.

I believe that CCSVI will prove to be beneficial in understanding MS.  Research into MS has become stagnant.  CCSVI may not prove out to be the end-all, but I think it will reinvigorate looking into an area that needs to be explored.  I've long thought that MS needs to be looked at outside the box which may prove that what we think we know about MS may be incorrect.  Maybe not all aspects, but perhaps a good many of them.

Really, there is very little known about MS with any level of certainty.  I'm not convinced it is an autoimmune reaction at all.

healthnut - I wish your brother luck.  Please let us know how he does.    
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