This Is MS Multiple Sclerosis Community: Knowledge & Support

Controlled clinical trials are only ethical if there are good reasons to believe a new treatment is as good as -- and perhaps better than -- a standard of care. That way, doctors performing these studies do not violate their duty to advance the best interests of patients who enrol. So in the case of venous angioplasty, trials would be ethical if there is solid evidence that venous insufficiency is a plausible hypothesis. We might get this from large, well-designed observational studies of MS patients. Animal experiments could also be informative. I am not a neurologist, but my understanding is the CCSVI theory is not nailed down, and cannot account for a number of features about the course of MS.

Q: Some Canadian MS patients who have undergone the procedure and experienced complications have complained that doctors here have been unwilling to offer followup treatment. Could you explain the extent of a Canadian doctor's ethical obligation to treat these patients?

Doctors shouldn't ever judge their patients and treat them differently based on how they became injured. If someone gets injured in Mexico and returns to Canada for treatment, it shouldn't matter whether the injuries occurred from cliff diving, charity work or seeking non-validated treatments like venous angioplasty.

Q: Is a Canadian doctor obligated to redo a vein-opening procedure if the patient has complications?

No. A doctor would be obligated to treat the complications. However, if offering the procedure in the first place is ethically suspect, I don't see why a doctor would be obligated to provide the procedure once a patient suffers complications from it.

No. A doctor would be obligated to treat the complications. However, if offering the procedure in the first place is ethically suspect, I don't see why a doctor would be obligated to provide the procedure once a patient suffers complications from it.

Except in the CCSVI group it is to relieve MS symptoms, which don't appear in any of those other cases.

superior vena cava syndrome should've been on my list too. It has similar symptoms to CCSVI (cogfog, fatigue) that are relieved immediately after venoplasty.

And does this cause lesions as seen in MS?

But just to be sure, as in the title of the article, we are talking about an MS treatment, right?

Or can you treat a venous outflow obstruction disorder (highly associated with MS) by opening veins?

I don't think there's a consensus on venous outflow obstructions being highly associated with MS, so I wouldn't go either way.

concerned, it is your right to continue to question for yourself, but I am satisfied at the association that has been shown between CCSVI and MS.

All the best to your mom, who by every account is fortunate to have you for a son.