Dr. Zamboni at ISNVD

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

Dr. Zamboni at ISNVD

Postby Cece » Mon Feb 20, 2012 10:58 am

Dr. Zamboni's first hypothesis was a compression from bones. Found reflux in veins for 1st time in 2002

From 2002 Dr. Zamboni focused on flow abnormalities & intraluminal anomalies based on looking at pts who died from MS

Dr. Zamboni: CCSVI treatment is about stability, i.e., stopping progression, but it does not work for everyone #CCSVI #ISNVD #MS

Dr. Zamboni: 18 pts treated in actute relapse eith amazing results; must be distinguished from chronic progression #CCSVI #ISNVD

Dr. Zamboni: In acute relapse, improvement comes from improved perfusion; reversal can be quite significant #CCSVI #ISNVD

Dr. Zamboni: first azygos treated Dec 11, 2006; first jugular angioplasty Dec 13, 2006. Then proceeded to begin IRB study.

I did not know that he first found reflux in MS veins back in 2002. That was ten years ago.

No IRs since Dr. Zamboni have set up a study of the CCSVI procedure as a treatment for acute relapse. What if that's the easiest way to show that CCSVI treatment has a benefit? One group of MS patients treated with CCSVI venoplasty during acute relapse; the other group treated with steroids and current standard-of-care. Looking for quicker end to the relapse and less lingering damage at 1 month, 3 months, 6 months. This would not be a hard study to conduct.
Dr. Zamboni: A multidisciplinary team is essential for any centre researching CCSVI. Dr. Z gives credit to his team
Dr. Zamboni: post mitten studies showed intraluminal defects in addition to compression from bone
Dr. Fox's postmortem studies of MS patients also show intraluminal abnormalities.
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Re: Dr. Zamboni at ISNVD

Postby Cece » Tue Feb 21, 2012 10:26 am

from p 79 of ISNVD 2012 abstracts:
Venous Angioplasty In Multiple Sclerosis: Long Term Clinical Outcome Of A Cohort Of Relapsing-Remitting

Fabrizio Salvi , MD, PhD; Ilaria Bartolomei , MD, PhD; Elena Buccellato , BS; Erica Menegatti , PhD; Roberto
Galeotti , MD; Paolo Zamboni , MD.

Purpose: To report long term clinical outcome of endovascular treatment for chronic cerebrospinal venous
insufficiency (CCSVI) in patients with multiple sclerosis (MS).

Methods: Twenty-nine patients with clinically-definite relapsing remitting MS received percutaneous
transluminal angioplasty for CCSVI at a distance from a clinical relapse and had a regular follow-up extending
at least 2 years both before and after the first endovascular treatment (mean postoperative follow-up 31 months).

Results: Overall 44 endovascular therapy sessions were performed without major complications.
Thirteen of 29 patients (45%) received more than one treatment session because of venous restenosis.
The annual relapse rate of MS was significantly lower postoperatively (0.45+/-0.62 vs 0.76+/-0.99; p=0.021),
but it increased in 4 patients. The Expanded Disability Status Scale (EDSS) 2 years after treatment was
significantly lower compared to the EDSS at the visit obtained 2 years before treatment (1.98+/-0.92 vs 2.27+/-
0.93; p=0.037), but it was increased in 4 patients.

Conclusions: Endovascular treatment of concurrent CCSVI is safe and repeatable and can reduce the annual
relapse rates and the cumulative disability in patients with RR-MS. Randomized controlled studies are needed to
further assess the clinical effects of endovascular treatment of CCSVI in MS.
Now this is long-term follow-up, at an average of 2 1/2 years post-treatment.

a tweet from Anne Kingstom:
Paolo Zamboni says an engineering model shows "there's more blood trapped in the necks of CCSVI patients"
An engineering model, or plethysmography?
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