Venous Multiple Sclerosis Hypothesis | CCSVI

• [zamboni10e] Zamboni P, and Galeotti R: The chronic cerebrospinal venous insufficiency syndrome. Phlebology. 2010 Dec;25(6):269-79. PMID 21106999, doi:10.1258/phleb.2010.009083.
  Vascular Disease Centre, Interventional Radiology Unit, University of Ferrara, 44100 Ferrara
  Abstract

  Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure. Restenosis rate was found out elevated in the IJVs, but negligible in the AZ. However, PTA seems to positively influence clinical and QoL parameters of the associated MS and warrants further randomized control trials.
• [ludyga10a] Ludyga T, Kazibudzki M, Simka M, Hartel M, Swierad M, Piegza J, Latacz P, Sedlak L, and Tochowicz M: Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe? Phlebology. 2010 Dec;25(6):286-95. PMID 21107001, doi:10.1258/phleb.2010.010053.
  EUROMEDIC Specialist Clinics, Department of Vascular & Endovascular Surgery, Katowice, Poland.
  Abstract

  The aim of this report is to assess the safety of endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI). Although balloon angioplasty and stenting seem to be safe procedures, there are currently no data on the treatment of a large group of patients with this vascular pathology.

The 2010 April;29(2) issue of International Angiology Journal is dedicated to CCSVI and contains 13 articles. Another article appeared in Neurology.

1. [zamboni10c] Zamboni P: Chronic cerebrospinal venous insufficiency. Int Angiol. 2010 Apr;29(2):91-2. PMID 20351663. PDF , Article$.
   Vascular Diseases Center, University of Ferrara, Ferrara, Italy
2. [embry10a] Embry AF: Integrating CCSVI and CNS autoimmunity in a disease model for MS. Int Angiol. 2010 Apr;29(2):93-4. PMID 20351664. PDF , Article$
   Direct-MS, Calgary, AL, Canada
3. [lee10a] Lee AB, Laredo J, and Neville R: Embryological background of truncular venous malformation in the extracranial venous pathways as the cause of chronic cerebro spinal venous insufficiency. Int Angiol. 2010 Apr;29(2):95-108. PMID 20351665. PDF , Article$.
   Department of Vascular Surgery, Georgetown University Hospital, Washington DC, USA.
4. [simka10b] Simka M, Kostecki J, Zaniewski M, Majewski E, and Hartel M: Extracranial Doppler sonographic criteria of chronic cerebrospinal venous insufficiency in the patients with multiple sclerosis. Int Angiol. 2010 Apr;29(2):109-14. PMID 20351666. PDF , Article$
   Department of Angiology, Private Healthcare Institution SANA, Pszczyna, Poland
5. [al-omari10a] Al-Omari MH, and Rousan LA: Internal jugular vein morphology and hemodynamics in patients with multiple sclerosis. Int Angiol. 2010 Apr;29(2):115-20. PMID 20351667. PDF , Article$.
   Radiology Department, King Abdullah University Hospital, Jordan University of Science and Technology, Jordan.
6. [menegatti10a] Menegatti E, Genova V, Tessari M, Malagoni AM, Bartolomei I, Zuolo M, Galeotti R, Salvi F, and Zamboni P: The reproducibility of colour Doppler in chronic cerebrospinal venous insufficiency associated with multiple sclerosis. Int Angiol. 2010 Apr;29(2):121-6. PMID 20351668. PDF , Article$.
   Vascular Diseases Centre, University of Ferrara, Italy
7. [hojnacki10a] Hojnacki D, Zamboni P, Lopez-Soriano A, Galleotti R, Menegatti E, Weinstock-Guttman B, Schirda C, Magnano C, Malagoni AM, Kennedy C, Bartolomei I, Salvi F, and Zivadinov R: Use of neck magnetic resonance venography, Doppler sonography and selective venography for diagnosis of chronic cerebrospinal venous insufficiency: a pilot study in multiple sclerosis patients and healthy controls. Int Angiol. 2010 Apr;29(2):127-39. PMID 20351669. PDF , Article$.
   The Jacobs Neurological Institute, State University of New York, Buffalo, NY, USA
8. [zamboni10b] Zamboni P, Menegatti E, Weinstock-Guttman B, Schirda C, Cox JL, Malagoni AM, Hojnacki D, Kennedy C, Carl E, Dwyer MG, Bergsland N, Galeotti R, Hussein S, Bartolomei I, Salvi F, Ramanathan M, and Zivadinov R: CSF dynamics and brain volume in multiple sclerosis are associated with extracranial venous flow anomalies: a pilot study. Int Angiol. 2010 Apr;29(2):140-8. PMID 20351670. PDF , Article$.
   Vascular Diseases Center, University of Ferrara-Bellaria Neurosciences, Ferrara and Bologna, Italy
9. [haacke10a] Haacke EM, Garbern J, Miao Y, Habib C, and Liu M: Iron stores and cerebral veins in MS studied by susceptibility weighted imaging. Int Angiol. 2010 Apr;29(2):149-57. PMID 20351671. PDF , Article$.
   Department of Radiology, Wayne State University, Detroit, MI, USA; Department of Radiology, the First Affiliated Hospital, Dalian Medical University, Dalian, China
10. [zivadinov10a] Zivadinov R, Schirda C, Dwyer MG, Haacke ME, Weinstock-Guttman B, Menegatti E, Heininen-Brown M, Magnano C, Malagoni AM, Wack DS, Hojnacki D, Kennedy C, Carl E, Bergsland N, Hussein S, Poloni G, Bartolomei I, Salvi F, and Zamboni P: Chronic cerebrospinal venous insufficiency and iron deposition on susceptibility-weighted imaging in patients with multiple sclerosis: a pilot case-control study. Int Angiol. 2010 Apr;29(2):158-75. PMID 20351672. PDF , Article$.
    Buffalo Neuroimaging Analysis Center, University at Buffalo, Buffalo, NY, USA
11. [malagoni10a] Malagoni AM, Galeotti R, Menegatti E, Manfredini F, Basaglia N, Salvi F, and Zamboni P: Is chronic fatigue the symptom of venous insufficiency associated with multiple sclerosis? A longitudinal pilot study. Int Angiol. 2010 Apr;29(2):176-82. PMID 20351673. PDF , Article$.
    Vascular Diseases Center, University of Ferrara, Ferrara, Italy
12. [bartolomei10a] Bartolomei I, Salvi F, Galeotti R, Salviato E, Alcanterini M, Menegatti E, Mascalchi M, and Zamboni P: Hemodynamic patterns of chronic cerebrospinal venous insufficiency in multiple sclerosis. Correlation with symptoms at onset and clinical course. Int Angiol. 2010 Apr;29(2):183-8. PMID 20351674. PDF , Article$.
    Center for Rare and Neuroimmunitary Diseases, Department of Neurological Science, Bellaria Hospital, Bologna, Italy
13. [plasmati10a] Plasmati R, Pastorelli F, Fini N, Salvi F, Galeotti R, and Zamboni P: Chronic cerebro-spinal venous insufficiency: report of transcranial magnetic stimulation follow-up study in a patient with multiple sclerosis. Int Angiol. 2010 Apr;29(2):189-92. PMID 20351675. PDF , Article$.
    Department of Neurology, Bellaria Hospital, Bologna, Italy2 Vascular Diseases Centre, University of Ferrara, Italy
14. [marrie10a] Marrie RA, Rudick R, Horwitz R, Cutter G, Tyry T, Campagnolo D, and Vollmer T: Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis. Neurology. 2010 Mar;74(13):1041-7. PMID 20350978, doi:10.1212/WNL.0b013e3181d6b125, PDF , Article$. Interview.
    Health Sciences Center, GF-533, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada

• Simka M et al.: Reinterpreting the magnetic resonance signs of hemodynamic impairment in the brains of multiple sclerosis patients from the perspective of a recent discovery of outflow block in the extracranial veins. [simka10a]

• Zamboni et al.: Endovascular Treatment for Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: A Longitudinal, Magnetic Resonance Imaging, Blinded Pilot Study. [zamboni10a]
• Lee BB et al.: Embryological Background of Truncular Venous Malformation in the Extracranial Venous Pathways as the Cause of Chronic Cerebro-Spinal Venous Insufficiency. [prep_lee10a]

• Presentation: [pres_dake10b]
• Conference: [conf_sir10a]
• Webcast. Starts at 45' 30'', slide 356 and ends 1h04', slide 436.

Presentations of "CCSVI Workshop on MS Feb 7, 2010" are available [ws_hamilton10_2]

• Zivadinov R: CCSVI and MRI Outcomes in MS. [pres_zivadinov10a]
• Al-Omari M, Rousan L: CCSVI: Evidence from Jordanian experience. [pres_al-omari10a]
• Haacke EM: Is the Basic Etiology of Multiple Sclerosis Vascular in Origin? [pres_haacke10a]
• Dake MD: Locations and etiologies of extracranial venous lesions in MS. [pres_dake10a]
• Simka M: Preliminary results of preoperative diagnostics and endovascular treatment for CCSVI. [pres_simka10a]
• Zamboni P: CCSVI: Implications in Multiple Sclerosis [pres_zamboni10a]

New videos to venous Multiple Sclerosis are available:

• Stent OP of Dr. Simka, Poland
• CCSVI and Multiple Sclerosis of Prof. Zamboni