Thursday, 26 November 2009

CCSVI - Statement from Professor Philip James & Our Medical Advisers

We have had several MS Therapy Centres asking about our view on Chronic Cerebrospinal Venous Insufficiency - CCSVI. Various articles and news clips have been published on the net. Prof James has sent an email to the author Dr Zamboni to find out more about the surgical procedure and we will keep you informed of any developments.

Please find attached a document to be circulated to your members, operators, staff etc.

Kind regards


Dr Petra Kliempt
Hon. NHS Specialist Trainer in Hyperbaric Medicine
MS-National Therapy Centres Co-ordinator

Attached from Prof James:

The recent publicity given to the work of Professor Paolo Zamboni has highlighted a growing disaffection with the concept of ‘auto’ immunity which has dominated MS research and treatment for more than half a century. Zamboni trained as a vascular surgeon specializing on problems of leg veins, which often leak as we age, allowing red blood cells into the surrounding tissues. When the red cells break down they liberate iron which causes damage to the walls of veins and the surrounding cells. Similar damage was found in the veins in the centre of the typical ‘plaques’ of multiple sclerosis as long ago as 1863. However, the use of an animal model for MS research after WW2 led to the concept of auto immunity where, it is claimed, the immune system attacks normal tissue. Despite sixty years of research there is no evidence of this and it remains just a theory. What is certain is the damage in MS involves veins and inflammation and Professor Zamboni has focused on these proven observations. He noticed, when using ultrasound scanning of the neck in a Multiple Sclerosis patient, that blood flowed the wrong way in a vein and also that the vein appeared to be constricted. After more investigations he has used the same procedure used to stretch arteries in the heart to relieve the vein constrictions. Several patients have found the procedure beneficial, greatly reducing their symptoms although stretching the veins will not affect existing scarring. There has been no indication of why the veins constrict, although increased ‘reactivity’ of blood vessels has been reported before in MS patients. Professor Zamboni’s work has highlighted the importance of the blood-brain barrier. Oxygen is responsible for the genetic control of inflammation and lack of oxygen has been shown in affected areas in MS patients by brain imaging. Neurologists are likely to remain sceptical of vein stretching until a ‘controlled’ study is done in which a sham procedure is used and compared to a group of matched patients who have the real procedure undertaken.

Philip B James MB ChB DIH PhD FFOM

Emeritus Professor of Medicine University of Dundee

Honorary Medical Adviser MS Therapy Centres