CCSVI and Multiple Sclerosis
Does CCSVI Really Exist? continued...
Why have researchers gotten such different results? One reason is that research teams use different criteria to evaluate CCSVI.
"The way the ultrasound is conducted is not yet standardized," says Robert Fox, MD, staff neurologist and medical director at the Cleveland Clinic Mellen Center for MS. "It's not like getting a blood count." He found that when people were examined with different types of scans, the number of CCSVI cases changed.
The difference in results could also have to do with something as basic as how much water study participants had to drink before their scans. "If you don't have a lot of volume in the veins they're going to collapse down," Fox says. When he had study participants drink Gatorade before their ultrasound, many of them no longer had signs of CCSVI. "Once you fill up the veins, you have much more blood flowing through them, and they're much more plump."
Even though researchers are still divided on whether CCSVI exists, some studies have started looking at the effects of treating it with surgery.
Zamboni and other researchers have been studying whether treating CCSVI by opening up blocked veins can improve symptoms of MS. The treatment for CCSVI is called endovascular surgery, or sometimes "liberation therapy" or the "liberation procedure." It involves placing a tiny balloon or tube called a stent inside a blocked vein to open it and restore blood flow out of the brain and spinal cord.
When Zamboni studied this surgery in a group of MS patients, he found that it did reduce relapses and the number of new brain lesions. Other studies have not found the same improvement. Some people with MS who've had the endovascular procedure claimed they felt better afterward, but researchers say this may be due to people's high hopes about the surgery outcome.
Should You Be Treated for CCSVI?
CCSVI is treated with surgery, and any type of surgery can have risks. "There have been some patients who have been seriously injured or have died as a result of this surgery," Fox says. Risks involved with endovascular surgery include:
- Movement of the stent
- Damage to the blood vessel, which could lead to clots
- Bleeding from the blood thinners prescribed after surgery
- Re-closing of the vein after surgery--called restenosis