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lördag, augusti 09, 2014

Goodbye CCSVI

CCSVI means that the blodflow from the brain is limited by defect veins with abnormalities.
In 2009 the Italian vascular surgeon Zamboni diagnosed CCSVI with ultrasound technique and he also reported about 65 RRMS patients who were operated on the condition using angioplasty to improve the blood flow. The patients seemed to feel better after the procedure
The theory was that the stagnation of blood in the veins caused inflammation and CNS lesions.
If the theory about CCSVI had been correct Zamboni would have received  the Nobel prize. Now no chance.

Many patients were fascinated by this procedure and the MS doctors also took notice. Primarily MS doctors were not as fascinated as the patients and meant that the obtained results could be due to the placebo effect. Lots of patients got irritated and formed CCSVI associations which campaigned for studies, but many patients meant that no further studies were needed and wanted that the procedure should be accepted with the results Zamboni had and that this was enough.
Large studies of CCSVI were done in eg Buffalo near Niagara Falls. Reports showed that the condition existed but not only in MS patients. Moreover, it was hardly more common in MS patients.
The largest pressure group was the forum This is MS formerly a forum to discussing everything about MS from the western medicine to alternative medicine but now all was CCSVI. One could say that the forum were taken over by the CCSVI debate and r there seems to be more posts about CCSVI than all the other posts together, more than 100,000 posts. Last year the interest declined and now seems to be zero.
Now, the first controlled study on CCSVI is presented.The investigators are the same who made ​​the major studies in Buffalo among others Robert Zivadinov and BiancaWeinstock-Guttman. They were also neutral regarding the CCSVI procedure and went in to investigate this without bias in my opinion.
The study is small but controlled. 19 people with relapsing forms of MS. 9 people undergoing vascular surgical angioplasty and 10 underwent a sham procedure. There were no complications with the procedure. They found no lasting improvement in the group receiving a genuine expansion. But 5 out of 9 in the group which underwent the genuine procedure had increased disease activity on MRI compared to 2 persons of 10 in the other group.
A small study but together with the earlier results it is time to put the CCSVI into the garbage. If this is a study about a drug to be this would be the consequence. It is a pity no such study was done in the beginning.
This is valuable knowledge about CCSVI but also about other alternative cures which are not studied enough.

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