a positive CCSVI study from Sapienza University, roma

[gibbledygook]

Phlebology. 2013 Nov 15. [Epub ahead of print]
Prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: a blinded sonographic evaluation.
Tromba L, Blasi S, Vestri A, Kiltzanidi D, Tartaglia F, Redler A.
Source
Department of Surgical Sciences, Umberto I Hospital, Sapienza University, Rome, Italy.
Abstract
OBJECTIVES::
To verify the prevalence of chronic cerebrospinal venous insufficiency in patients affected by different clinical forms of multiple sclerosis and in healthy subjects using the Zamboni ultrasound protocol combined with M-mode ultrasound examination.
MATERIALS AND METHODS::
We enrolled 112 patients with multiple sclerosis and 67 healthy subjects from 20 to 67 years of age. All the patients underwent Duplex and color-Doppler sonography of the neck vessels, transcranial colour duplex sonography, M-mode study of the valve system and of venous abnormalities. Subjects were positive for chronic cerebrospinal venous insufficiency when at least two of five hemodynamic criteria of the Zamboni protocol were fulfilled. Chronic cerebrospinal venous insufficiency condition was further analyzed by a multivariate analysis including age, sex, disease duration, subtypes of multiple sclerosis and expanded disability status scale score as independent variables.
RESULTS::
No healthy subjects was positive for chronic cerebrospinal venous insufficiency, while in the sample of patients affected by multiple sclerosis the diagnosis was made in 59.8% of cases (p < 0.0001). The first criterion was the most frequent in patients affected by multiple sclerosis and chronic cerebrospinal venous insufficiency (respectively 54.4% and 76.1%, p < 0.001). The second, third and fourth criteria were never present in healthy subjects but were detected in patients with multiple sclerosis. The positivity of the second criterion was associated with diagnosis of chronic cerebrospinal venous insufficiency in 100% of cases. The third criterion had a prevalence of 52.2% in the subgroup of chronic cerebrospinal venous insufficiency patients. It was positive in 36 multiple sclerosis patients and was associated with chronic cerebrospinal venous insufficiency diagnosis in all cases except one.The multivariate analysis showed that age, disease duration, sex, subtypes of multiple sclerosis and expanded disability status scale score were not considered predictors of this haemodynamic condition.
CONCLUSION::
Chronic cerebrospinal venous insufficiency is a haemodynamic condition strongly associated with multiple sclerosis and is not found in normal controls. The addition of M-mode ultrasound to the diagnostic protocol allows improved observation of venous valve abnormalities.
KEYWORDS:
M-mode, Multiple sclerosis, Zamboni's protocol, chronic cerebrospinal venous insufficiency, venous abnormalities

[ton]

And now?

[chowder1]

YAY!

My story: I had CCSVI 2 years ago in New Jersey by Dr. McGluckin (spelling??) but had little improvement. BUT, I am for it because my life turned upside down less than a month after CCVSI......I was diagnosed with breast cancer and had to start chemo a couple of months after that, therefore, I was NOT ABLE to see results. I know we are all different and it has worked well for others, so I am still positive about it. I tried to have it again last year, but insurance will no longer pay for it!! So frustrating!! My veins showed definite blockage, but I'm sure I re-stenosed while trying to deal with cancer at Christmas:( And, btw, at the time I was going to have CCSVI done, I told my neuro. He wasn't really for it, but I asked, "Well, will it hurt me?" And he had to say no. And I had to comment that the Tysabri I had been on for 3 years could, so I was trying this.

I really hope this becomes a treatment because the CRAB drug stink! Thanks for posting the study:)

[frodo]

The pseudo-doctors and neurologist soon will say that no relationship has been found in other blind studies, and that therefore we should not take this into account.

They forget (intentionally) that a positive in a blind study has a value higher than a negative. In fact orders of magnitude higher. A negative value in a blind experiment in fact means nothing. Even myself can obtain that result (no, I am not a doctor or anything related)

[ThisIsMA]

Wow! Very impressive.

Now, will this study get some press? Maybe our CCSVI nonprofits can put out press releases to their respective national and local news agencies.

[CureOrBust]

This paper will not be read by many neurologists, as it was / will be published in "Phlebology. 2013 Nov 15" something I would hazard a guess is not on their reading lists.

[Cece]

This paper will not be read by many neurologists, as it was / will be published in "Phlebology. 2013 Nov 15" something I would hazard a guess is not on their reading lists.

I'll settle for it being read by interventional radiologists. It would be nice to see CCSVI raise in prominence at the usual conferences (ISET, SIR, etc).

[centenarian100]

It is amazing how variable the results can be from different investigators. 59.8% vs. 0% is fairly impressive. One would think this would be so easy to replicate.

[Robnl]

If you want to replicate the results, it's easy indeed........

[Cece]

It is amazing how variable the results can be from different investigators. 59.8% vs. 0% is fairly impressive. One would think this would be so easy to replicate.

Considering the variable results, it is apparent that sonography is an unreliable way to diagnose this.
I think catheter venography plus IVUS by an IR with considerable experience in CCSVI is preferable. Also, autopsy studies.

[1eye]

It is amazing how variable the results can be from different investigators. 59.8% vs. 0% is fairly impressive. One would think this would be so easy to replicate.

Without asking why it is that phlebologists' opinions on "MS" in one blinded study have less value than neurologists' opinions on veins in another, one could speculate about one group having less to gain than the other has to lose. I might add that the correspondence between specialization of the researchers and results of the study do not have any scientific basis, but are singular in their consistency.

That some of the researchers are lying? That could never happen. Especially in an area where the patients are poor and suffering, and both groups and are so rich in comparison. They have their reputations to consider. National pride? I can't figure it out, but I would have thought people who have no cognitive difficulties could figure it out better than this. I guess nobody is in any hurry to resolve it. Certainly we patients have nothing to gain or lose, so we aren't in any big rush. I just can't understand why we spend so much time and energy discussing it. I guess it just must be that BOI (Bad Ol' Internet).

[cheerleader]

Wow! Very impressive.

Now, will this study get some press? Maybe our CCSVI nonprofits can put out press releases to their respective national and local news agencies.

Belleve me, we try....the best we can do now is house all of the research on our searchable data base.
http://ccsvi.org/index.php/component/se ... ask=search

The press is not interested in research published in Phelbology. (I've asked.) They look at impact scores for journals.
We have a real problem, in that the positive studies are being published in mainly vascular journals, which do not rank as highly as the neurological journals and their continued slew of negative studies and opinion pieces.

Thank goodness for the ISNVD--bringing together multidisciplinary researchers, to publish together--in neurological journals.
cheer