Does the Multiple Sclerosis
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 Multiple Sclerosis 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 Multiple Sclerosis 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 Multiple Sclerosis 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.