CCSVI and the PTA procedure – Brief outline

In 2006 an Italian Professor at the University of Ferrara, Dr Paolo Zamboni, embarked on work which is likely to have worldwide repercussion on the understanding and treatment of the collection of neurological symptoms referred to as Multiple Sclerosis (MS). When his wife was diagnosed with those symptoms, Zamboni, a cardiovascular professor, 'went back to his books' to research, convinced that the circulation played a significant role, a view supported by aetiological theory as far back as 160 years ago. He found there were no adequate techniques available to study the vasculature associated with the neural system and developed protocols and techniques to investigate this issue. His early studies revealed an extremely high incidence of venous abnormalities in patients diagnosed with MS, specifically very unhealthy blockages (stenoses) of the internal jugular and azygos veins. The extremely unhealthy consequences of these blockages are detailed below. Zamboni named the condition Chronic Cerebro-Spinal Venous Insufficiency (CCSVI). Shortly after that he utilised a commonly used procedure Percutaneous Transluminal Angioplasty (PTA) to rectify the problem. One of his colleagues called it the Liberation procedure, to describe the freeing up of the Central Nervous System from its state of toxicity.

What is CCSVI?

CCSVI essentially means that the veins in the neck do not drain the brain and the top of the spinal cord effectively. There are three main veins that have the job of returning the blood from the brain and spinal cord to the heart: the two internal jugulars and the azygos vein. Either or all of these veins may be constricted, blocked, have faulty valves or may even be missing altogether. It appears from recent research that this problem is something people are born with, so we can say with some confidence that CCSVI comes before MS as it has been detected in babies in womb. We can't say for certain that CCSVI causes the lesions: there are many theories, the most common of which is that it is an auto-immunity disease. There needs to be further research done before we can determine the course of events. Many studies over the years have suggested that neurological conditions including Alzheimer and Parkinson may also involve poor blood drainage of the brain.

The PTA procedure

Once the problem has been located, all that is needed is a simple, minimally intrusive intervention to widen the veins where they are constricted. This can be achieved in two ways: the preferred method is to guide a tiny deflated balloon up to the point of constriction and once there to inflate it to stretch the constriction. The second way this can be achieved is to insert a stent into the vein at the point of constriction. A stent is a very fine wire mesh tube which is very flexible and soft. It is inserted in the vein and using the balloon it is then stretched open to allow the blood to flow freely. Although intervention is at an early stage of development many controlled studies are already under way and there have been some very encouraging outcomes.

Reported improvements include a return to normal temperature of hands and feet. Many MS patients suffer from cold extremities and within a few minutes of the procedure their hands and feet are warm again. Many patients report improvements to their level of fatigue, and other commonly improved symptoms are heat tolerance, tremors, spasms, urinary problems, cognitive problems and brain fog. Each patient has their own set of symptoms so these improvements differ from person to person.

The process involves a number of tests, including Magnetic Resonance Imaging (MRI), Magnetic Resonance Venography (MRV), and the Doppler Ultrasound. All of which are explained below, as are a number of other terms you might hear when discussing CCSVI.