Chronic cerebrospinal venous insufficiency
| Chronic cerebrospinal venous insufficiency | |
|---|---|
 |
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| Veins of the neck. V.jugularis interna is proposed to be stenosed or have a malformed valve in CCSVI cases. | |
| Classification and external resources | |
| Specialty | cardiology |
| ICD-10 | I87.8 |
| MeSH | D014689 |
Chronic cerebrospinal venous insufficiency (CCSVI or CCVI) is a term developed by Italian researcher Paolo Zamboni in 2008 to describe compromised flow of blood in the veins draining the central nervous system. Zamboni hypothesized that it played a role in the cause or development of multiple sclerosis (MS). Zamboni also devised a procedure which was termed by the media as "liberation procedure" or "liberation therapy", involving venoplasty (or stenting) of certain veins in an attempt to improve blood flow.
Within the medical community, both the procedure and CCSVI have been met with skepticism. Zamboni's first published research was neither blinded nor did it have a comparison group. Zamboni also did not disclose his financial ties to Esaote, the manufacturer of the ultrasound specifically used in CCSVI diagnosis. The "liberation procedure" has been criticized for possibly resulting in serious complications and deaths while its benefits have not been proven. The United States Food and Drug Administration states that it is not clear if CCSVI exists as a clinical entity and that these treatments may cause more harm. In 2017 they emphasized that this use of balloon angioplasty is not an approved use.
Research on CCSVI has been fast tracked but researchers have been unable to confirm whether CCSVI has a role in causing MS. This has raised serious objections to the hypothesis of CCSVI originating multiple sclerosis. Additional research investigating the CCSVI hypothesis is underway. A 2013 study found that CCSVI is equally rare in people with and without MS, while narrowing of the cervical veins is equally common.
Proposed consequences of CCSVI syndrome include intracranial hypoxia, delayed perfusion, reduced drainage of catabolites, increased transpulmonary pressure, and iron deposits around the cerebral veins.Multiple sclerosis has been proposed as a possible outcome of CCSVI.
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