Multiple sclerosis (MS) is a disease in which the fatty myelin sheaths (electrical insulating material) around the nerve fibres of the brain and spinal cord are damaged.
Depending on which nerves are involved his leads to eventual impairment in sensation, movement, cognition, or other functions.
For this reason, multiple sclerosis has been considered and treated as a neurological disease.
In 2008, Dr.
Paolo Zamboni, a vascular surgeon from Italy, conducted a preliminary study in participants afflicted with multiple sclerosis.
In over 90% of the participants, through a process involving ultrasound and venography, he identified several problems, like narrowing and defective valves, in veins draining their brain.
(1) This resulted in restricted outflow of blood from the brain which created a high level of accumulation of iron deposits in the brain which trigger an autoimmune response, and inflammation of the blood brain barrier.
His conclusion was that the majority of his MS patients had chronic cerebrospinal venous insufficiency (CCSVI).
In other words their venous systems were unable to efficiently remove the blood from the central nervous system.
He performed a surgical procedure called a balloon angioplasty to open up the problematic veins.
His findings reported that 73% of his patients experienced considerable improvement in their symptoms.
(2) Multiple sclerosis has been proposed as the outcome of CCSVI.
Iron deposits have long been documented in MS lesions and it is well known that every MS lesion forms symmetrically around a vein.
Unfortunately, because Dr.
Zambonis' studies were not randomly controlled ( he did not test non-MS patients) to eliminate selective bias, their results would not be accepted by the medical communities in Canada and the United States.
The treatment for CCSVI, named the liberation procedure, is currently not available in Canada and the United States.
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.
The next day the patient usually undergoes ultrasound testing to confirm that the problematic veins have stayed open and are functioning well.
Countries such as Italy, Poland, Egypt, India and Germany are performing this treatment with results ranging from some improvement to total reversal of symptoms.
The news is out and MS patients are shouting loud and clear that testing for this treatment should be made available to help anyone suffering from the effects of this disease.
There seems to be a split amongst the medical communities as to the validity of this treatment.
Despite numerous reports of improvements in MS patients who have undergone the procedure, there currently is a restriction in Canada to perform this treatment for MS patients.
Reasons stated include that there have not been a sufficient number of controlled studies performed to confirm that the treatment is appropriate that the improvements in symptoms are due to placebo effect that impairment of the problematic veins could recur.
Yet, other medical professionals have commented that it should be no different than performing angioplasty for a heart condition - test for the venous impairment and if necessary correct it.
The current therapy for MS is mainly drug therapy.
The main aim of the drug therapy is to recover function after an attack or relapse, to prevent new attacks from occurring and to prevent disability.
It is unfortunate that many drug therapies are very expensive, they carry with them adverse side effects and they do not address the problem of venous insufficiency.
Thus far, drug therapies have been unable to prevent the progression of deterioration.
The liberation procedure, which is 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.
The cause of the CCSVI remains an unknown, however, if the liberation procedure can liberate MS patients from their symptoms and help them return to a functional life, it should be the goal of our governments and medical communities to help make this happen.
Perhaps the biggest hurdle to overcome is to reclassify multiple sclerosis as a result of a venous disorder rather than a neurological one.
Current studies being performed by neurologists on this subject are being questioned for bias as MS patients cry out for studies to be performed by Interventional Radiologists and Vascular Surgeons.
Perhaps the best case scenario would be for both groups to work together for the common goal of what is best for the patient.
References: (1) and (2) Wikipedia