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MS Article or Multiple Sclerosis Article:

 How does the MS News

About MS CCSVI Apply to

You With Multiple Sclerosis?

Does the MS news about the possible MS CCSVI link, which was part of the results announced in 2009, from the initial Dr. Zamboni study for MS patients with CCSVI apply to you, with Multiple Sclerosis?

In case you are not that familiar with the initial Dr. Zamboni study with its results and conclusions, it was aired across Canada as a discovery announcement in November of 2009.

Dr. Paolo Zamboni, a vascular surgeon, conducted a 2-year study with 120  MS patients in Ferrara, Italy and found that 90% of the MS patients in the study had blockages in the veins draining blood away from the brain.

This resulted in much higher concentrations of iron in the brain of the MS patients, which also had the blocked or partially blocked veins of the brain.

The blood flow blockages to the veins in the neck and/or the upper chest are the result of a condition called chronic cerebrospinal venous insufficiency or CCSVI.

CCSVI is a condition, where veins, either one or both of the jugular veins in the neck or in the veins of the zygote process, which is located in the upper chest on either side of the chest, are totally or partially blocked, restricting blood flow away from the brain.

According to Dr. Paolo Zamboni of Ferrara, Italy, there appears to be some kind of link between Multiple Sclerosis and the CCSVi condition, but to what degree, that has yet to still be determine through further studies and observations performed during further MS research on the MS and CCSVI link. 

This interesting discovery has peaked the curiosity of the medical community around the world, with some reactions being positive and some being more skeptical.

Dr. Zamboni also observed, that due to the dysfunction of drainage of the veins for the people with Multiple Sclerosis, the blood reverses back into the brain, where extra iron is deposited.

To open up the blocked blood flow, Dr. Zamboni developed a surgical procedure, dubbed the "Liberation Treatment", to improve blood flow from the brain by inserting a catheter into the blocked vein and inflating a small balloon at the end of the catheter to open up the blood flow.

Initially, the procedure appeared to work on opening up the blocked blood flow and relieve many of the symptoms of Multiple Sclerosis, for those who had MS and CCSVI present together.

As more cases of the combination of Multiple Sclerosis and CCSVI are found, and as more of the procedures are being performed on MS patients around the world, there are a few problems, which are appearing in connection with the procedure.

After the procedure is performed to open up blocked blood flow, often the condition returns, requiring the procedure to be redone again.

To prevent the restricted blood flow in the blocked veins from returning, stents are often inserted into the vein, but at times dong this can cause other problems, which are a possible result of using stents.

Stents can present problems, including:

* blood clots forming

Blood clots can form around the stents, causing other problems with blocking the blood flow.

* blood clots can break off

When the blood clots break off and travel to the brain, the heart or the lungs, this can create a much more serious problem, which can sometimes result in death of the patient.

* stents can dislodge

Stents can also potentially travel to the brain, the heart or the lungs, and can potentially also cause death of the patient.

Since stents are not typically used in the veins of the neck or the upper chest, this can present other serious health consequences, yet unknown.

Keep in mind, that the announcement of Dr. Zamboni's findings or the MS news about MS CCSVI may or may not apply to you, but it may be worth being evaluated for the blockages to see it this applies to your case of Multiple Sclerosis or not.

All major surgeries come with risks, but since the presence of MS and CCSVI together is a fairly new concept, the procedure for opening up the blood flow has not been developed to the point where it is safe and effective for reducing the symptoms of MS, while minimizing problems, which can be associated with the methods used for opening up the blocked veins for a longer period of time.

But since the idea of the connection between Multiple Sclerosis and the CCSVI condition or the blood flow blockages is still in its infancy, it may be worth delaying getting the procedure done, if you do have the blockages, along with MS, while keeping a closes watch on where the MS research leads in this area.

Since a procedure has been developed that can help open up the restricted blood flow to the blood vessels that lead to the brain (using a catheter inserted into the affected veins and inflating a small balloon in the blood vessel to open up the restricted veins), it is at least worth being evaluated for these blockages to determine if is something that can help us with helping to reduce the MS symptoms.

Do blood flow problems to the brain or Chronic cerebrospinal venous insufficiency (CCSVI) apply to all of the people diagnosed with Multiple Sclerosis?

According to the studies, which have been done already, as of May 2011, it appears that there are people, both with and without Multiple Sclerosis, which appear to have the CCSVI condition, but it appears that people diagnosed with Multiple Sclerosis have a much higher incident rate of having the CCSVI condition, than people without the MS diagnosis.

According to the study of MS patients, performed in 2010 Buffalo, New York of the USA, it appeared that approximately 50% of the MS patients in the study had the presence of the CCSVI condition, which results in blockages to the blood flow leaving the brain.

Not enough studies have been performed with MS patients to confirm or deny the initial findings, but it appears that there is some kind of link between Multiple Sclerosis and the CCSVI condition, which was found in the initial Dr. Zamboni study, performed in Ferrara, Italy, with the results being announced towards the end of 2009.

The initial study done in Buffalo, New York was not considered conclusive, but it did suggest that at least 50% of the MS patients studied had the CCSVI blood flow blockages  described by Dr. Paolo Zamboni of Ferrara, Italy in 2009.

Additional studies are being considered in a few countries around the world, where the incident rate of MS is much higher.

Studies in the UK are being considered and are being planned for several places throughout Canada in 2011.

There is also a different type of MS CCSVI study being led by Dr. Hubbard in San Francisco, California, where the MS patients in the study are being evaluated for collecting data on MS patients, where the CCSVI blockages are found, the MS patients are offered the procedure for opening up the blockages where found.

The San Francisco study is more of data collection method to gather more data on the effects of the the blood flow blockages and the procedure on MS patients.

Gathering more data on MS and CCSVI can potentially help to speed up the process which may result in a double blind placebo study of MS patients, which is the gold standard of the evaluation process of the overall medical community.

But the more in depth studies, which can include a larger group of MS patients appears to be a longer way off -- even up to 15 to 20 years in the future, if it is performed at all.

Funding sources for the larger and more complex studies is one of the major roadblocks to a thorough evaluation of the CCSVI condition for MS patients.

As of May 2011, the methods of testing for the presence of CCSVI in MS patients include:

* Doppler ultra sound testing

* Magnetic Resonance Imaging or MRI

* Magnetic Resonance Vein Imaging or MRVI

Other methods of testing may become available as more MS research is persued on the presence of Multiple Sclerosis along with the CCSVI condition.

As of May of 2011, the methods of testing and evaluating MS patients for CCSVI needs to be standardized and agreed upon by the world wide medical community.

In addition, the procedure for opening up the blood flow blockages, which are found, needs to be tested and standardized for efficacy and safety to ensure what method can be use, while minimizing the risk to Multiple Sclerosis patients.

Stents have been used with some of the procedure and can pose other health risks, such as forming blood clots or with the stints breaking free and lodging themselves in the brain or the heart causing more severe health problems and maybe even death.

In addition, the actual procedure for opening up the restricted blood flow and the method for lengthening the time the blood flow remains opened up he MS patients needs to be agreed on and evaluated by the overall worldwide medical community for efficacy and safety of the MS patients undergoing the procedure.

What tests are used for screening people, diagnosed with Multiple Sclerosis, to see if the CCSVI blockages are present?

Testing procedures, up until May of 2011, include using Ultrasound tests and MIRVIs, although the MRVI testing is a much better test for testing the veins for the blockages of CCSVI.

MRVI is fairly similar to  having a MRI done, but the MRVI is specifically done for the veins.

Ultrasound tests can be done to determine if your particular case of Multiple Sclerosis has
restricted blood flow to and/or from the brain, as an element that may be part of what may be contributing to your symptoms of Multiple Sclerosis, but in some cases of MS, it appears that the blockages are positional and there are times, where using ultrasound testing may not detect the blockages, since the person typically lies down for the ultrasound tests to be performed.

The reactions of the medical community around the world appears to be skeptical overall about the most recent MS news about the possible MS CCSVI link, but there are more studies popping up in different locations through out the USA, as well as more vascular doctors or surgeons that are at least willing to evaluate MS patients to see if this problem does definitely exist.

Other studies may also be appearing in different countries around the world, where Multiple Sclerosis is appearing more often, as a result of the release of the information that Dr. Paolo Zamboni discovered about the MS patients that he has been working with in Ferrara, Italy.

Since Saskatuwan, Canada, has a very high incident rate of Multiple Sclerosis, within a smaller local area, MS and CCSVI studies are being considered by Canada in Saskatewan and other locations throughout Canada.

Although there can be some partial blockages to the carotid arteries, that supply blood flwo to the brain, the findings of Dr. Zamboni point out that 90% of the MS patients that he studied and worked with had restricted blood flow going away from the brain.

Unfortunately, the veins that take the blood away from the brain aren't tested very often by the majority of doctors.

Consequently testing to locate any restrictions that are currently present in the veins in the neck need that drain the blood away from the brain need to be discussed specifically with your doctors to find out if this may apply to your case of Multiple Sclerosis.

MS patients can also have circulation problems in the legs, especially if more problems exist with the reduced abilities to walk or stand.

The more time that is spent sitting and not moving around as much, reduces blood flow to the legs and increases the number of problems with circulation in the legs that can become more of a problem.

Circulation problems in the legs can include blood clots, stenosis, varicose veins, 

I have been tested for blood flow problems to the legs before

Blood flow problems  in the legs,including possible blood clots, restricted blood flow or stenosis of the veins in the legs may also be considered for being tested, since often Ms patients that lack more of the abilities to stand or walk can have more problems with circulation.

There are many doctors, who still think that the MS news about the idea of a possible MS CCSVI link for people, diagnosed with Multiple Sclerosis, to be speculative.

This means that there may be neurologists and/or vascular surgeons, who are not interested in testing MS patients for the presence of CCSVI.

Because of the speculative or even experimental nature of the idea behind the testing for the presence of CCSVI for people, diagnosed with Multiple Sclerosis, many insurances will not cover the costs of the tests needed to be done to evaluate MS patients for the presence of the CCSVI condition or cover the surgery or procedure that can be done to open up the blood flow to blocked veins.

Paying for the tests out of pocket can be a very expensive endeavor.

Finding doctors willing to request the tests and finding out if your health insurance covers the costs of the testing are the first 2 steps in the process for being evaluated for MS CCSVI.

Since the testing is not a very difficult test to have done, it may be worth considering having the ultrasound testing done, as an initial screening, but in some cases, having the MRVI testing performed is a much better way of detecting the presence of CCSVI.

Talk to your doctor about all of this before you decide what is best for you.


Keep in mind, vascular doctors can request the tests for the carotid arteries and possible venous insufficiency, stenosis, blood clots, etc. in the legs, but to have the testing done for the veins in the upper chest, more often than not you have to go to the cardiologist to request these tests.

The cardiologist can also test to see if the heart and the heart valves are functioning well or not.

Some of the tests require having a neurologist request the tests too, when considering ways to get the evaluation done, while having a better chance at having health insurance being willing to cover the costs of the testing for the presence of the CCSVI condition.

Whatever you decide, whether to wait for having the screening done for CCSVI, until the testing and the procedure have been standardized and safety procedures have improved or if you are willing to take more of a risk and have the testing and/or procedure done, be sure that whatever facility does perform the procedure to open up the blocked veins is willing to provide follow up after the procedure, in case of complications.

It is your choice, whether to pursue looking into any newer procedure or treatment for Multiple Sclerosis or not, especially when it comes to Multiple Sclerosis and CCSVI.

Finding well trained and well qualified doctors is vital, if you are considering going for the evaluation of the presence of the Multiple Sclerosis CCSVI condition for you.


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