Zivadinov’s Update On Chronic Cerebrospinal Venous Insufficiency (CCSVI) In Multiple Sclerosis

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Robert Zivadinov, MD, PhD provides a thoughtful update on the current status of chronic cerebrospinal venous insufficiency (CCSVI) research in multiple sclerosis. Zivadinov predicts the debate about the role of CCSVI will likely continue as more research is conducted to determine the best methods for treating patients who are diagnosed with this condition.

"Research to determine how to diagnose CCSVI, how and whether it should be treated, and whether the treatment benefits patients with MS is just getting under way."

Masters of Multiple Sclerosis, provider of expert commentary on MS research, examines the current status of research related to chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis. CCSVI, when the flow of blood in the veins draining the central nervous system is compromised, has generated great interest as a possible cause for the development of multiple sclerosis. Robert Zivadinov, MD, PhD reviews current research initiatives and the possible relationship of CCSVI and the pathogenesis of MS (http://www.mastersofms.com).

Dr. Zivadinov is Associate Professor of Neurology with Tenure at the University of Buffalo, the State University of New York and Director of the Buffalo Neuroimaging Analysis Center.

Procedures to evaluate and treat CCSVI are still in the early research stages. Zivadinov conducted a small pilot study with Dr. Paolo Zamboni’s group in Italy, 16 MS patients with severe documented CCSVI were given intravascular treatment with percutaneous transluminal angioplasty (PTA) either immediately or following a 6-month delay. The one-year findings of that study will be presented at the 2010 ECTRIMS meeting in Sweden in October. Additionally, Zivadinov’s group is undertaking a larger placebo-controlled trial in RRMS patients. Larger and better controlled studies are warranted to definitively evaluate the possible impact of CCSVI on MS and determine if an endovascular surgical procedure would be effective.

Visit Masters of Multiple Sclerosis (http://www.mastersofms.com) for additional information on CCSVI mechanism, its relationship with MS and Dr. Zivadinov’s current recommendations for diagnosis and treatment for this condition.

Suggested reading: Zamboni P, Galeotti R, Weinstock-Guttman B, et al. Endovascular treatment for chronic cerebrospinal venous insufficiency in multiple sclerosis: a longitudinal, magnetic resonance imaging, blinded pilot study. J Vasc Surg. 2010;51:794.

Zamboni P, Galeotti R, Menegatti E, et al. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2009;80:392-399.

University at Buffalo, The State University of New York. First blinded study of venous insufficiency prevalence in MS shows promising results. Press release, Feb 10, 2010.

Zamboni P, Menegatti E, Galeotti R, et al. The value of cerebral Doppler venous haemodynamics in the assessment of multiple sclerosis. J Neurol Sci. 2009;282:21-27.

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Mary Beth Woodin

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