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There is no cure that is known for multiple sclerosis till date. Most treatments are known to slow the overall progression of the symptoms of the disease. More and more desperate patients are therefore turning to a surgical treatment of multiple sclerosis, proposed by Paolo Zamboni, a vascular surgeon from the University of Ferrara in Italy.
The surgical treatment has been widely criticized by experts in the field of Multiple Sclerosis. It has always been believed that MS is caused when the body’s immune system becomes self-destructive and attacks the layer of myelin present around the nerve fibers. However, Paolo Zamboni does not believe that MS is an autoimmune disease.
Chronic cerebrospinal venous insufficiency is caused by the narrowing down of certain specific veins in the neck and chest. This impedes the flow of blood and results in the accumulation of blood in the brain thereby causing an excess of iron buildup which damages myelin, the protein layer around the nerve fibers.
For treating this condition, Paolo Zamboni advocates the use of stents for opening up the veins that are responsible for carrying blood from the brain. The use of stents normalizes the flow of blood to the brain and eases the buildup of iron which, he believes, damages the myelin layer around the nerve fibers.
Zamboni performed his study on 65 patients suffering from MS, and he found CCSVI to be present in all of them. There were several controversies regarding this study as it was found that his hypothesis was biased. His study was not blinded to the placebo and treated groups and he knew exactly which patients had MS. Since the time this theory was publicized, thousands of MS patients flocked to the nearest clinics to opt for a neck venoplasty, also commonly referred to as the liberation therapy. The response and interest in Zamboni’s study has been so intense that the US National MS society has designated $2.4 million for studies to understand the correlation between CCSVI and MS.
Correlation between CCSVI and MS
Numerous studies have been undertaken post the claims made by Paolo Zamboni attributing CCSVI as a potential factor responsible for causing MS. Most of these studies have failed to find a correlation between CCSVI and MS. The largest study conducted about CCSVI till date was presented at the Congress of the European Committee for Treatment and Research in Multiple Sclerosis at Lyon, France. About 1202 people with MS were part of the study. This group was compared with 669 people who were either healthy or were suffering from some other neurological disorder. The study found that the prevalence of CCSVI was the same in all the three groups and CCSVI could therefore not be attributed as a causal factor for MS.
Another study (Prospective Randomized Endovascular Therapy in MS) was funded by the University of Buffalo and it found that endovascular angioplasty has no effect on MS patients. The U.S Department of Health and Human Services too states that there is no clear evidence that CCSVI is linked to MS and that opting for the liberation therapy does not has a positive impact on the symptoms of MS.
The FDA released a statement in May 2012 warning people about the risks associated with the liberation therapy for treating MS. Common risks associated with endovascular surgery include movement of the stent, damage to blood vessels leading to formation of clots, infection, and bleeding from blood thinners that are prescribed post surgery.