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Shelly Benjaminy, Andrew Schepmyer, Judy Illes, Anthony Traboulsee
BACKGROUND: Scientific and financial investments in chronic cerebrospinal venous insufficiency (CCSVI) research have been made to address both the hope for and scepticism over this interventional strategy for MS. Despite limited evidence in support of the CCSVI hypothesis, the funding of clinical research was responsive to a demand by the public rarely seen in the history of medicine. We characterize patient perspectives about the CCSVI research trajectory, with particular attention to its impact on other non-pharmaceutical areas of MS research with a focus on stem cell interventions...
May 16, 2018: BMC Health Services Research
Serkan Öner, Ayşegül Sağır Kahraman, Cemal Özcan, Zeynep Maraş Özdemir, Serkan Ünlü, Özden Kamışlı, Zülal Öner
Objective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI)...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Paolo Zamboni, Luigi Tesio, Stefania Galimberti, Luca Massacesi, Fabrizio Salvi, Roberto D'Alessandro, Patrizia Cenni, Roberto Galeotti, Donato Papini, Roberto D'Amico, Silvana Simi, Maria Grazia Valsecchi, Graziella Filippini
Importance: Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by restricted venous outflow from the brain and spinal cord. Whether this condition is associated with multiple sclerosis (MS) and whether venous percutaneous transluminal angioplasty (PTA) is beneficial in persons with MS and CCSVI is controversial. Objective: To determine the efficacy and safety of venous PTA in patients with MS and CCSVI. Design, Setting, and Participants: We analyzed 177 patients with relapsing-remitting MS; 62 were ineligible, including 47 (26...
January 1, 2018: JAMA Neurology
Erica Menegatti, Mirko Tessari, Maria Elena Vannini, Sergio Gianesini, Anna Maria Malagoni, Andrea Ciorba, Manuela Mazzoli, Francesco Sisini, Fabrizio Salvi, Stefano Pelucchi, Paolo Zamboni
BACKGROUND: High prevalence of valve absence was found in the internal jugular vein (IJV) of healthy volunteers by means of M-mode high-resolution Echo Colour Doppler (ECD). However, the prevalence of valve in neurovascular disorders linked to Chronic Cerebrospinal Venous Insufficiency (CCSVI) is still unknown. METHODS: A cohort of 83 Healthy Controls (HC), 71 Multiple Sclerosis (MS), 99 Inner Ear Disorders (IED) underwent ECD investigation of the IJV valve, including M-mode evaluation and related hemodynamics...
2017: Current Neurovascular Research
S Michelle Driedger, Ryan Maier, Ruth Ann Marrie, Melissa Brouwers
BACKGROUND: In recent years, shared decision making (SDM) has been promoted as a model to guide interactions between persons with MS and their neurologists to reach mutually satisfying decisions about disease management - generally about deciding treatment courses of prevailing disease modifying therapies. In 2009, Dr. Paolo Zamboni introduced the world to his hypothesis of Chronic Cerebrospinal Venous Insufficiency (CCSVI) as a cause of MS and proposed venous angioplasty ('liberation therapy') as a potential therapy...
September 7, 2017: BMC Neurology
Maria Grazia Caprio, Karen Marr, Sirin Gandhi, Dejan Jakimovski, Jesper Hagemeier, Bianca Weinstock-Guttman, Robert Zivadinov, Marcello Mancini
BACKGROUND: An impaired cerebrospinal venous drainage was postulated to be a cofactor in the multifactorial pathogenesis of multiple sclerosis (MS). Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by abnormalities of the main extracranial cerebrospinal venous outflow routes, which can be detected by color Doppler Ultrasound (CDUS) using 5 venous hemodynamic (VH) criteria. Discrepant results between different investigators were reported in the past, therefore the usefulness and applicability of the CCSVI CDUS-based diagnosis in clinical research and practice has been questioned...
2017: Current Neurovascular Research
Paul Thibault, John Attia, Chris Oldmeadow
Objective Chronic cerebrospinal venous insufficiency (CCSVI) is a condition associated with multiple sclerosis (MS). One mechanism that has been proposed is that the venous obstructions found in MS are due to a chronic persistent venulitis caused by the intra-cellular bacterial parasite, Chlamydophila pneumoniae (Cpn). The objective of the current study is to determine the effect of a combined antibiotic protocol (CAP) on the venous flow in MS patients as measured by a quantitative duplex ultrasound examination (QDUS)...
January 1, 2017: Phlebology
Maha M A Zakaria, Shahira Y Mikhael, Azza K Abu Hussein, Rania A Salah El-Din, Hany W Abd El-Malak, Iman H Hewedi, Hany S Nadim
<i>Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. The present study was designed to validate this hypothesis using a rat model of CCSVI. Bilateral jugular vein ligation (JVL) was performed on female albino rats (n = 15), and sham-operated rats (n = 15) were used as a control group...
2017: Folia Neuropathologica
Sani J Laukontaus, Johanna Pekkola, Jussi Numminen, Tomoko Kagayama, Mauri Lepäntalo, Markus Färkkilä, Sari Atula, Pentti Tienari, Maarit Venermo
BACKGROUND: Doppler ultrasound (US) has been widely used to evaluate the cervical venous system of multiple sclerosis patients according to the hypothesis of chronic cerebrospinal venous insufficiency with contradictory results. Venous anatomy and pathology can be examined with less operator-dependent magnetic resonance imaging (MRI). Our aim is to assess the interobserver agreement in measuring internal jugular vein (IJV) cross-sectional area (CSA) in MR images and to explore the agreement between US and MRI in the detection of calibers of ≤0...
March 11, 2017: Annals of Vascular Surgery
A Dessa Sadovnick, Irene M Yee, Kristen Attwell-Pope, Glenn Keyes, Lucas Kipp, Anthony L Traboulsee
Objective Chronic cerebrospinal venous insufficiency (CCSVI) has been hypothesized to be a risk factor for multiple sclerosis (MS). Venoplasty has been proposed as a treatment for CCSVI. The aim of our study was to gain a better understanding of the "real-world" safety and longitudinal effectiveness of venoplasty Methods: British Columbia residents who self-reported having had venoplasty and consented to participate in the study were interviewed and followed for up to 24 months post-therapy using standardized structured questionnaires Results: Participants reported procedure-related complications (11...
May 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Aldo Bruno, Marisanta Napolitano, Luigi Califano, Giuseppe Attanasio, Vincenzo Giugliano, Pier Paolo Cavazzuti, Marika Viccaro, Eleonora Masci, Diego Mastrangelo, Francesca Salafia, Salvatore Mazzone, Benedetto Bernardo, Laura Cagnoni, Roberto Filipo, Marco De Vincentis, Antonio Greco
PURPOSE: To evaluate relationship between Meniere disease (MD) and chronic cerebrospinal venous insufficiency (CCSVI) using ultrasound, magnetic resonance (MR) imaging, and venography and to evaluate the effectiveness of angioplasty of the internal jugular vein (IJV) and azygos vein (AV) in reducing symptoms of MD. MATERIALS AND METHODS: Patients with a confirmed diagnosis of MD unresponsive to standard treatment underwent duplex ultrasound and MR imaging to diagnose CCSVI...
March 2017: Journal of Vascular and Interventional Radiology: JVIR
Giuseppe Attanasio, Laura Cagnoni, Eleonora Masci, Francesco Ciciarello, Francesco Diaferia, Aldo Bruno, Antonio Greco, Marco De Vincentiis
CONCLUSION: The present study confirms a correlation between chronic cerebrospinal venous insufficiency (CCSVI) diagnosis and Ménière's disease (MD). CCSVI could be considered a new ultrasound vascular pattern of the cerebrospinal venous system in patients affected by definite MD. Conversely, the present results showed that CCSVI cannot be considered a pathogenic mechanism for idiopathic sudden sensorineural hearing loss (ISSNHL). OBJECTIVES: The aim of this study is to investigate the correlation between CCSVI and MD and to evaluate if CCSVI can be considered a risk factor also for ISSNHL...
May 2017: Acta Oto-laryngologica
Aldo Bruno, Gennaro Quarto, Luigi Califano, Diego Mastrangelo, Marcella De Vizia, Francesca Salafia, Benedetto Bernardo
PURPOSE: The authors have evaluated by ultrasound the CCSVI in Meniere's Disease. MATERIALS AND METHODS: 140 patients with diagnosis of Meniere's Disease, who have had not improvement to usual therapy, underwent echo color Doppler sonografy by Zamboni's protocol for the diagnosis of CCSVI . 128 were positive. RESULTS: Ultrasound diagnosis of CCSVI was performed in patients with Meniere's Disease with a positivity in 128 patients on 140 examinated (90% of cases)...
2016: Annali Italiani di Chirurgia
Gabriela Cardaioli, Massimiliano Di Filippo, Alessia Bianchi, Paolo Eusebi, Maria Di Gregorio, Lorenzo Gaetani, Antongiulio Gallina, Paolo Calabresi, Paola Sarchielli
The etiology of multiple sclerosis (MS) is still largely unknown and it has been proposed that an impaired venous drainage from the central nervous system, defined as chronic cerebrospinal venous insufficiency (CCSVI), may play a role in this. We investigated the prevalence of extracranial venous drainage pattern alterations in a cohort of MS patients based on the 2011 revised diagnostic criteria for CCSVI. Thirty-nine MS patients and 18 healthy subjects underwent blinded extra-cranial venous echo-color Doppler sonography to reveal the presence of CCSVI...
2016: European Neurology
M Paoletti, G Germani, R De Icco, C Asteggiano, P Zamboni, S Bastianello
Scientific debate over chronic cerebrospinal venous insufficiency (CCSVI) has drawn attention to venous system involvement in a series of pathologic brain conditions. In the last few decades, the MRI venography (MRV) field has developed a number of valuable sequences to better investigate structural anatomy, vessel patency, and flow characteristics of venous drainage in the intra- and extracranial systems. A brief two-tier protocol is proposed to encompass the study of intra- and extracranial venous drainage with and without contrast administration, respectively...
2016: Behavioural Neurology
Sandro Mandolesi, Alessandro d'Alessandro, Tarcisio Niglio, Aldo Bruno, Benedetto Bernardo, Dimitri Mandolesi, Antonella Caroli, Aldo d'Alessandro, Francesco Fedele
OBJECTIVES: Aims of this study were to investigate the prevalence of reflux on internal jugular veins(IJV) by Valsalva maneuver and to define the association between reflux of IJV in subjects with both CCSVI and MS. METHODS: We recruited 393 patients with MS and CCSVI. Study participants underwent EchoColor Doppler exam in order to define IJV diameter at confluence in subclavian (JSd). Subjects were divided in three groups: group "1<JSd<6 mm" (subjects with jugular diameter less than 6mm); group "6≤JSd<10 mm" (subjects with jugular diameter equal or more than 6 but less than 10); and group "JSd≥10 mm" (subjects with jugular diameter equal or more than 10 mm)...
2016: Annali Italiani di Chirurgia
Setareh Ghahari, Susan J Forwell
BACKGROUND: We conducted a rigorous review of videos related to multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI) treatment posted by people with MS on one social media website (YouTube) that describe symptoms before and after the surgical procedure, as well as videos presented by health-care professionals (HCPs). METHODS: All relevant videos posted from December 2009 to July 2011 were downloaded, viewed, and systematically organized...
March 2016: International Journal of MS Care
Luanne M Metz, Jamie Greenfield, Ruth Ann Marrie, Nathalie Jette, Gregg Blevins, Lawrence W Svenson, Katayoun Alikhani, Winona Wall, Raveena Dhaliwal, Oksana Suchowersky
BACKGROUND: Many Canadians with multiple sclerosis (MS) have recently travelled internationally to have procedures for a putative condition called chronic cerebrospinal venous insufficiency (CCSVI). Here, we describe where and when they went and describe the baseline characteristics of persons with MS who participated in this non-evidence-based medical tourism for CCSVI procedures. METHODS: We conducted a longitudinal observational study that used online questionnaires to collect patient-reported information about the safety, experiences, and outcomes following procedures for CCSVI...
May 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Sandro Mandolesi, Giuseppe Marceca, Aldo d'Alessandro, Antonello Desogus, Matteo Marco Ciccone, Annapaola Zito, Ettore Manconi, Tarcisio Niglio, Dimitri Mandolesi, Alessandro d'Alessandro, Francesco Fedele
PURPOSE: The complete compression of the internal jugular veins, in front position, shows a prevalence of 48% and it is equally distributed in the various segments of these veins in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and Multiple Sclerosis (MS). The aim of this search is to identify radiological dislocation of C1-C2 as specific markers in patients with CCSVI and Multiple Sclerosis (MS). METHOD: We investigated 386 patients suffering from CCSVI and Multiple Sclerosis and a control group of 156 patients without MS...
July 2015: Annali Italiani di Chirurgia
Aldo d'Alessandro, Tarcisio Niglio, Antonello Desogus, Alessandro d'Alessandro, Dimitri Mandolesi
A Multiple Sclerosis patient with chronic cerebrospinal venous insufficiency (CCSVI) treated by acoustic waves, modulated in frequency and power of the Dreno-MAM® device, showed a progressive improvement in motor coordination, resistance to work, muscular power and rigidity, and distal microcirculation. Life quality, chronic fatigue, and clinical severity questionnaires EDSS show marked improvements with a follow-up of two years. We suggest that the method could be also used in the chronic fatigue syndrome and other neurological diseases such as Parkinson or Meniere syndrome...
July 2015: Annali Italiani di Chirurgia
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