Endovascular venous procedures for MS? Commentary ???

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby PCakes » Fri Jul 16, 2010 1:43 pm

If collateral circulation is an adequate alternate.. why did i lose a dear friend to heart disease last year? ..his heart had held on for a few years pumping blood only through collateral arteries but sadly he is gone.
Yes, our bodies have an amazing preservative instinct but in most cases this only allows time to fix the problem.
Fix the problem!! get it!!
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Postby Cece » Fri Jul 16, 2010 1:44 pm

1eye, I don't always understand what you're saying, but I love the way you say it. I am also against enslavement of the veins and for the internet underground railroad that is bringing our veins to freedom. :)
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
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More Proof that CCSVI Does NOT Exist from the Pill Pushers

Postby Squeakycat » Wed Jul 28, 2010 12:34 am

Editorial comment on the article.

This is the editorial overview of the article explaining the dangers of CCSVI "from the perspective of experts in cerebral vascular anatomy," one in a series of recent articles aimed at undermining CCSVI by the pill pushers.
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Postby TMrox » Wed Jul 28, 2010 5:35 am

Here an extract of the comment article "Endovascular venous procedures for multiple sclerosis?"

A well-recognized feature of the jugular and vertebral venous systems in the neck is the way in which they respond to changes in body orientation: during upright position the vertebral plexus takes over nearly all of the jugular venous outflow,5 suggesting that a great deal of adaptability and autoregulation also exist in the venous neck drainage system. The interesting correlation between jugular venous obstruction and demyelinating disease found by Zamboni et al.1,2,8 recently, has therefore come as a surprise because the cerebral venous system appears, at least in theory, to cope quite well with low flow. Neck surgeons have for a long time occluded the jugular veins during radical neck surgery to treat cancer and they have largely succeeded without seeing significant hemodynamic changes of the intracranial pressure doing each side’s ligation in stages. Uneventful outcomes exist even in cases of simultaneous bilateral jugular ligation.9 To the best of the authors’ knowledge there are no reports of clinical or neuroimaging findings resembling those of demyelinating disease after those procedures. Similarly, we have not seen imaging changes resembling MS in patients suffering jugular thrombosis from central lines inserted in intensive care unit (ICU) patients. Put simply, the vertebral venous system appears to compensate efficiently for impaired flow in the jugular veins.

If we follow the venous system caudally, parallel to the jugular system, the drainage of the posterior neck and cervical spine takes place through a complex and rich vertebral plexus that eventually proceeds to the brachiocephalic veins, one on each side. These large trunks converge into the superior vena cava (SVC). The azygos vein joins the superior vena cava before the latter reaches the right atrium.10 The upper third of the thoracic spine drainage is through the superior intercostal veins that flow into the azygos and left hemiazygos in 75% of cases. In the remainder the superior intercostal veins end in the brachiocephalic trunks. The mid, lower thoracic and lumbosacral spine venous drainage is largely shared by the lumbar, azygos, and sacral veins. Hence, the azygos system is a back up venous route for the vena cava arrangement,11 in cases of vena cava obstruction. It would be surprising if insufficiency of a collateral system such as the azygos were enough to alter the well-adjusted spinal venous homeostasis and produce the spinal manifestations of MS.

In well-documented cases of venous hypertension created by the presence of a high flow lesion such as dural Arteriovenous (AV) fistula, any spinal cord lesions present on MRI have very different characteristics from a demyelinating plaque. The former feature is a significant edematous swelling involving the whole segment of the spinal cord and not a single lesion in the posterior columns.

Then the article discusses about the challenges of treating the azygous and jugular veins with stenting and rate of restenosis. The comment concludes with:

We embrace the challenge of understanding better the relationship between chronic venous insufficiency and MS through future studies. While Zamboni et al.’s theory is assessed, the least we can do is to remain prudent, understanding that angioplasty or stenting of the jugular and/or azygos veins cannot be considered safe or well-known therapies. If ongoing research proves there is a role for venous intervention in MS, certainly research for devices better suited for veins will also be necessary.
Diagnosed with Transverse Myelitis in December 2008. Inflammatory demyelination of the spinal cord (c3-c5). No MS, but still CCSVI.
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