http://www.sciencedirect.com/science/ar ... 8X1200006X
Ultrasound investigation of intracranial and cervical veins is highly operator dependent owing to the wide anatomic and physiological variability of these vessels. Therefore a study of cerebral venous drainage requires very experienced neurosonographers, but most importantly, blinding algorithms are mandatory in assessing MS patients especially during venographic verification of ultrasound findings; these were completely omitted in Zamboni's studies. To this day, a scientifically sound validation of each of the five criteria proposed by Zamboni for the diagnosis of CCSVI is missing, not to mention their combined application. Concurrently, there is growing evidence which rejects the role of CCSVI in the pathogenesis of MS and which suggests that the proposed CCSVI criteria are questionable due to miscitation, manipulation of known data and methodological flaws. Thus, any potentially harmful interventional treatment such as transluminal angioplasty and/or stenting should be strongly discouraged, not only for the lack of any evidence, but also for the risk of serious peri-procedural complications.