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The publication of these findings unleashed an emotionally intense controversy that currently
still forments with boiling points of view. From highly critical reaction that decry the concept of CCSVI as a hoax that provides false hope to vulnerable and desperate, individuals to supportive testimonials from treated patients, the debate surrounding the existence, association and relevance of CCSVI to MS is reflected in the contributions to the medical literature. Although, the vast majority of the articles on the topic consist of commentaries, opinions, interpretations and diatribes, rather than reports of clinical evidence for or against CCSVI, the essence of the recently published independent clinical studies designed to evaluate various aspects of the CCSVI hypothesis do, by and large, reflect the opposing public contentions in the dispute by presenting conflicting results that either pointedly question, or support the existence of CCSVI. At present, our level of understanding is simply insufficient to settle the argument.

So back to the question at hand, is CCSVI an entity and a subset of MS? On the basis of the significant body of evidence generated from multispecialties across the globe, the answer to that question would be YES. From its initial description, over the past several years, many investigators have continued to add to rapidly evolving scientific evidence that identifies CCSVI association with MS and maybe even other neurodegenerative disorders. As with any new therapy and particularly with MS, the initial learning curve is steep, and many of the publications have emerged without a standardized approach to the diagnosis, intervention, adjunctive treatments, and critical endpoint analysis. It would have been impossible for any single individual, institution, or specialty to discover a phenomenon, invent a procedure, and identify all of its perceived benefits, particularly in a disease state as elusive as MS. Our understanding of CCSVI and its implications in MS patients has evolved significantly over the past several years and today MS societies worldwide are committing millions of dollars to CCSVI related research projects. The ongoing collaborative efforts among national and international multidisciplinary research teams to better understand the implications of CCSVI in MS is underway, and it is likely that this evidence will help shape the future treatment strategies for not just MS patients but also those with a variety of other neurodegenerative disorders.