Chronic CerebroSpinal Venous Insufficiency or CCSVI describes a compromised blood flow in the veins, while the central nervous system drains. So, it plays a vital role in the development of Multiple Sclerosis or MS. MS is proposed to be a possible cause or outcome from CCSVI. In CCSVI, there is a blockage found in the veins for the patient, who suffers from this condition. The blockage blocks or obstructs the blood flow. The result will be insufficient flow of blood through the nervous system. many of the researches were performed on the relation of the CCSVI and MS.
The consequences of CCSVI syndrome are:
- Delayed perfusion
- Iron deposited around the cerebral veins
- Intracranial hypoxia
- Catabolites reduced drainage
- Increased transpulmonary pressure
Diagnosis of CCSVI is described through specialized extracranial sonography and transcranial Doppler sonography. There are five ultrasound criteria are proposed for venous drainage to ensure the characteristic of the syndrome. However, two of them having positive are considered to be sufficient.
- Reflux found in the deep cerebral veins
- Reflux found in the vertebral veins and internal jugular
- Internal jugular vein high-resolution B-mode ultrasound evidence for stenosis
- Flow absence in the vertebral veins or internal jugular, found in Doppler ultrasound
- Main cerebral venous outflow pathways reverted postural control
CCSVI, which is related to the multiple sclerosis has a possible treatment, venous angioplasty. Stenting and balloon angioplasty are proposed as the optional treatment for CCSVI in MS. Through venous angioplasty, adequate flow of blood through the nervous system can be ensured.
Venous angioplasty is a minimally invasive procedure. So, it does not need the traditional open procedure. The blockage can be treated by placing a stent inside the vein and also prevents the veins from further closing. A guided wire along with fogram map is used by the doctors to steer the catheter to pass through the vein that has been blocked. After the narrow point, where the blockage present, is reached, a small balloon, which is specially designed for this purpose is inflated to spread or widen the vein, so that the blockage can be removed. Depending on the clinical conditions, a stent may be placed and kept inserted in the place of blockage, which will be removed at later stages. After the blockage has been cleared, the balloon along with the catheter will be removed.
Through most of the procedures of stenting and angioplasty are safe to be performed, there are also severe complications possible with these treatments.
- Stent migration towards renal vein
- Intracranial lhemorrhage
- Cranial nerves XI and XII nerve compression syndrome
In many countries, the surgeries are not completely accepted, as still some more research has been expected to ensure that there will be no complications that would lead to major injuries to the patient. So, it is important that the patient discusses in detail with the surgeon and the team, regarding the outcomes and complications of the treatment.
Cost of CCSVI Testing & Venous Angioplasty for MS
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