CCSVI: Symptoms, Treatment, and Its Relationship to MS
CCSVI: More Questions Than Answers
A condition called chronic cerebrospinal venous insufficiency (CCSVI) has caused debate in the medical community.
Some researchers believe that CCSVI can lead to damage to the central nervous system in people with multiple sclerosis (MS). But this claim is controversial. Many MS organizations refute the link between CCSVI and MS, and believe further studies are needed.
Click through the slideshow to learn more about CCSVI and its possible link to MS.
CCSVI causes certain veins to narrow abnormally. The veins that are affected work by draining blood from your spinal cord and brain after your blood has been depleted of oxygen.
Some researchers believe that this condition can cause blood to flow back into your spine and brain through a process called reflux.
If this happens, it can cause your brain to have too little oxygen. It can also result in abnormal levels of iron in your tissues.
According to the Multiple Sclerosis International Federation (MSIF), “treatments for CCSVI remain unproven.” Researchers stopped certain types of surgical treatments at Stanford University due to adverse side effects.
MSIF advises avoiding such treatments, except in clinical trials. This is because they may result in heart injury and even death.
Some healthcare providers have used surgery to treat the condition, despite cautions raised from experts about safety concerns.
One such procedure involves using a balloon to help widen narrowing veins.
Another procedure, endovascular surgery, requires a surgeon to put stents into veins to help combat narrowing.
However, the MSIF notes that these procedures haven’t been used widely on people with CCSVI.
Link to MS?
In 2008, a study published in the Journal of Neurology, Neurosurgery & Psychology concluded that CCSVI is connected to multiple sclerosis (MS).
The study looked at 65 patients with MS, and researches worked to understand how blood drains from the spinal cord.
The study concluded that blood flow abnormality “plays a key role” in how MS progresses. The findings suggested that MS is “strongly associated” with CCSVI.
Many in the MS research community have disagreed with the study’s conclusion that CCSVI is connected to MS.
MSIF states that “The risks and benefits of procedures to treat CCSVI have not been established by properly controlled clinical trials.”
The organization thus advises avoiding CCSVI treatment until there is further proof of a clear link between CCSVI and MS.
The U.S. Food and Drugs Administration (FDA) agrees that “studies exploring a link between MS and CCSVI are inconclusive.”
Other Trials & Conflicting Evidence
More recent studies have also refuted the connection between CCSVI and MS.
A 2013 study by Rodger et al. examined 100 MS patients to determine whether a link exists.
Researchers concluded that their case-control study “provides compelling evidence against the involvement of CCSVI in multiple sclerosis.”
University of Buffalo researchers also reported differing results from the 2008 study. They concluded that additional studies were needed to prove that CCSVI affects MS.
Many MS organizations discourage the use of specific procedures to address CCSVI until more clinical evidence is available. However, the debate is ongoing.
Researchers are continuing to investigate:
- the possibility of a connection between CCSVI and MS
- how CCSVI may (or may not) affect MS symptoms
- the effectiveness (or lack thereof) of treatment for CCSVI in fighting MS
In the meantime, talk to your doctor if you or a loved one has MS. Your healthcare team can help you weigh the costs and benefits of the treatments options available.
- MSIF Statement on CCSVI. (n.d.). The Multiple Sclerosis International Federation (MSIF). Retrieved December 2, 2013, from http://www.msif.org/global-ms-research/msif-statement-on-ccsvi.aspx
- Chronic Cerebrospinal Venous Insufficiency (CCSVI). (2013, March 25). MSAA: Publications - Chronic Cerebrospinal Venous Insufficiency (CCSVI). Retrieved December 2, 2013, from http://www.mymsaa.org/publications/msresearch-update-2013/ccsvi/
- Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. (2008, December 5). Journal of Neurology Neurosurgy & Psychiatry (4): 392. Retrieved December 2, 2013, from http://jnnp.bmj.com/content/80/4/392
- FDA Safety Communication: Chronic Cerebrospinal Venous Insufficiency Treatment in Multiple Sclerosis Patients. (2012, May 10). U.S. Food and Drug Administration. Retrieved December 2, 2013, from http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm303318.htm
- Evidence against the Involvement of Chronic Cerebrospinal Venous Abnormalities in Multiple Sclerosis. A Case-Control Study. (n.d.). PLOS ONE. Retrieved December 2, 2013, from http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.007
- Additional Published Results from National MS Society-Funded CCSVI Study: National MS Society. (n.d.) National Multiple Sclerosis Society. Retrieved December 2, 2013, from http://www.nationalmssociety.org/news/news-detail/index.aspx?nid=80442495
- National Center for Biotechnology Information. (2010, March). Annals of Neurology. Retrieved December 2, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/20373339
- First Blinded Study of Venous Insufficiency Prevalence in MS Shows Promising Results. (2010, February 10). University of Buffalo News Center. Retrieved December 2, 2013, from http://www.buffalo.edu/news/releases/2010/02/10937.html