Study on surgery for CCSVI shows little benefit
08 June 2012
Author: MS Trust
A small study in Canada suggests no difference in people with MS being treated with venoplasty for CCSVI compared with those who had no treatment.
CCSVI (chronic cerebrospinal vascular insufficiency) is a controversial theory that MS is associated with abnormalities (including narrowing) in veins taking blood from the brain. As yet there is insufficient evidence to determine whether venous insufficiency is a cause of MS, a result of MS, or is unrelated.
Investigations are underway to establish the prevalence of CCSVI and whether it can be treated by unblocking the veins using a surgical procedure, known as percutaneous venoplasty or liberation treatment, which involves inflating a small balloon to open the narrowed veins.
The results of a small, observational study at Newfoundland's Memorial University, Canada, were announced this week. In the study, 40 people with MS underwent an array of tests before the venoplasty treatment and then at intervals of one month, three months, six months and one year after the procedure. These tests included questionnaires, MRI scans, and a standardised test used to assess function (manual dexterity, ability to walk and mental acuity).
The researchers found no difference between the 30 people who had been treated by the venoplasty and ten people who had not. The initial benefits reported by people who had received the procedure, such as more energy or better balance, tailed off over time, with a drop-off after three months. After a year, about a quarter had had a recurrence of blocked veins though showed no reduced function when compared to those where the blocked veins did not recur.
Based on the findings of the study, the health minister for Newfoundland and Labrador has recommended that the cost of CCSVI treatment will not be covered by the province.
In March 2012, NICE (the National Institute for Health and Clinical Excellence) recommended that surgery for CCSVI is only carried out as part of a clinical study as there is insufficient evidence to recommend routine NHS surgery for CCSVI.