Wednesday, March 24, 2010

And for a little bit of hope

I have been reading a lot about this recently - I think if you have MS there is no way you have not heard of this, but I was proud of the Akron Beacon Journal in printing this article.  Anyway, as you will see it a totally different approach to MS and a little bright spot of hope for MSers.

Read for yourself :)

WASHINGTON: Under intense pressure from patients, some U.S. doctors are cautiously testing a provocative theory that abnormal blood drainage from the brain may play a role in multiple sclerosis — and that a surgical vein fix might help.
If it pans out, the approach suggested by a researcher in Italy could mark a vast change for MS, a disabling neurological disease long blamed on an immune system gone awry. But many patients frustrated by today's limited therapies say they don't have time to await the carefully controlled studies needed to prove if it really works and are searching out vein-opening treatment now — undeterred by one report of a dangerous complication.
''This made sense and I was hell-bent on doing it,'' said Nicole Kane Gurland of Bethesda, Md., the first to receive the experimental treatment at Washington's Georgetown University Hospital, which is set to closely track how a small number of patients fare before and after using a balloon to widen blocked veins.
In Buffalo, N.Y., more than 1,000 people applied for 30 slots in a soon-to-start study of that same angioplasty procedure.
The demand worries Georgetown neurologist Dr. Carlo Tornatore, who teamed with vascular surgeon Dr. Richard Neville in hopes of getting some evidence to guide his own patients' care.
''A lot of people are starting to go to fly-by-night places,'' said Tornatore. Doing this research takes time, he said. ''It's a marathon, not a 100-yard sprint. We have to be very careful.''
Multiple sclerosis occurs when the protective insulation, called myelin, that coats nerve fibers gradually is destroyed and scar tissue builds up, short-circuiting messages from the brain and spinal cord to the rest of the body — impairing walking and causing fatigue and vision, speech, memory and other problems. It affects about 2.5 million people worldwide, including 350,000 Americans.
A condition with an unwieldy name has become the hottest topic of debate in MS: Chronic cerebrospinal venous insufficiency, or CCSVI. An Italian vascular specialist, Dr. Paolo Zamboni, was hunting ways to help his wife's MS when he discovered that veins carrying oxygen-depleted blood down the neck or spinal cord were narrowed, blocked or twisted in a group of patients. Zamboni reported that made blood back up in a way that might be linked to MS' damage.
Then came the step that spread excitedly through MS patient Internet forums: In a pilot study, Zamboni's team used balloon angioplasty — similar to a longtime method for unclogging heart arteries — to widen affected veins in 65 patients. He reported varying degrees of improvement.
But nearly half had their veins relapse, and Zamboni urged a larger, more scientifically controlled study be done.


allanjel said...

I know veins are quite distendable and do not have as much vascular resistance as arteries, so I can see how easy a relapse would be, but I am wondering what kind of effect a medicated stent would have on the vein, maybe some type of bypass graft/ venous shunt. Of course, I am assuming the issue manifests when mulitple vessels begin to have issues and there in lies the problem (it being more than just 1 vessel, that is).

Julia said...


I love that you come at this with a physiology background, I find the science of all of this very interesting.

Anyway, a doc in California did 25 venous stents. All of the patients are in primary progressive form of MS. Anyway, the stents are currently the same ones that they use for artery blockage to the heart, but are not working as well for veins (tends to move or cause extreme discomfort). Although all of the patients who have successful stents, also have lessening symptoms or at least no new attacks since the stent was put in.

Seems hopeful, now we need someone to develop a successful venous stent. :)