Timetable for NICE guidance on CCSVI
Author: MS Trust
NICE (the National Institute for Health and Clinical Excellence) has announced the timetable for its guidance on treatment for CCSVI.
Chronic cerebro-spinal venous insufficiency (CCSVI) is a theory that stenosis (an abnormal narrowing or obstruction) in blood vessels can cause inflammation and damage to cells in the central nervous system, leading to MS symptoms.
It has been proposed that CCSVI can be treated by surgical procedures to open the narrowed veins by inflating balloons (balloon angioplasty) or by inserting a stent (mesh tube) to support the vein.
The NICE Interventional Procedure Programme is about to start and as a stakeholder in this guidance the MS Trust has been given the following summary of the schedule:
10 June 2011
■First Interventional Procedures Advisory Committee (IPAC) meeting the evidence will be discussed and provisional recommendations drafted
21 July - 18 August 2011
■Consultation on the Draft recommendations
13 October 2011
■Second IPAC meeting The committee will consider the consultation comments and make changes to the guidance if necessary
MarkW wrote: Treating syndromes remains an established medical and pharmaceutical practice and must be adopted for CCSVI syndrome.
The most encouraging aspect of the whole proceedings was the strength of response from the consultees, (as they called the people who wrote to give them the benefit of their experience and their suggestions). Four hundred and forty (440) people wrote in, most of them in support of PTA for the treatment of CCSVI.
The issue of equality was discussed extensively and the committee had to agree that the procedure could not be described as anything but safe and that there was no reason why people with an MS diagnosis should not be treated via a venoplasty procedure, however they felt that the most important question not answered so far was whether this was an effective treatment for MS symptoms. Although there was plenty of evidence about the safety of the procedure, no one had published anything regarding its efficacy.
MarkW wrote:A logical discussion on efficiecy goes like this:
1 - treating CCSVI syndrome is balloon venoplasty is safe.
2 - valve issues are treatable by balloon venoplasty.
3 - do valve issues remain resolved after the procedure ????
There is no published paper which show that the vein valves treated remain treated after 1 or 3 or 6 or 12 months. This is the simple step wise research which needs to happen.
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