Consensus Document of the International Union of Phlebology (IUP) – 2009

A consensus conference on venous malformations[uip09] – headed by Prof. Byung B Lee from Georgetown – and experts from 47 countries – studied the evidence and unanimously voted in favour of officially including the stenosing lesions found in CCSVI in the new Consensus document and Guidelines.


This paper can be brought to interventional radiologists and vascular surgeons. CCSVI lesions are classified as a truncular venous malformations - which means that vascular doctors have now classified this disease, CCSVI, as congenital- and preceding MS lesions.


The International Union of Phlebology (IUP), the largest international organization devoted to the investigation and management of venous disorders, established an expert panel to formulate guidelines for physicians and health care professionals around the world on the evaluation and treatment of venous malformations (VMs).
The aim of this document is to provide recommendations for the diagnosis and treatment of VMs based on the best currently available scientific evidence. When scientific evidence was lacking or weak, a consensus of opinions among expert members of the panel was reached to support the recommendations.

Truncular lesions of obstructive nature (webs, hypoplasia) may have different hemodynamic impacts on their relevant vascular systems depend ing upon their location, extent/severity, and natural compensation through collaterals. Chronic venous insufficiency develops in the territory drained by the truncular vein. Stenosing truncular lesions produce venous obstruction leading to a reduction in venous drainage. Membranous obstruction of the inferior vena cava in primary Budd-Chiari Syndrome is an example of a primary obstructive VM affecting a major vein.

Truncular VM lesions may also occur in veins with the same embryologic origin or draining the same territory (e.g., stenosing lesions of the extracranial jugular veins, superior vena cava, and azygos vein system along the main outflow pathways of the cerebro-spinal venous system as suspected cause of multiple sclerosis).96-99

98 = [zamboni09b]

Reference: CCSVI in Multiple Sclerosis: News from Dr. Zamboni- CCSVI lesions classified as congenital