Another small negative CCSVI study

A
Epub ahead of print: Auriel et al. Extra-cranial venous flow in patients with multiple sclerosis. J Neurol Sci. 2011 Aug 3.

27 MS’ers were compared to healthy control subjects.

Results: Except for one MS’er, blood flow direction in the internal jugular veins was normal in all subjects. 
No significant difference was found between subjects and controls.
Conclusion:  The investigators found no evidence to suggest that MS’ers have an excess of CCSVI. In addition they failed to observe a typical venous flow pattern in MS’ers. Until carefully designed controlled studies to investigate CCVSI have been completed, invasive and potentially dangerous endovascular procedures as therapy for MS should be discouraged.
“No commentary necessary on this one.”

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

3 comments

  • In the absence of Prof. G sharing this encouraging news, here is more information from the Buffalo angioplasty trail:

    The MRI technicians were blinded as to who was in which group. All patients were on disease modifying drugs before, during and after, for consistency in treatment. The first ITG (immediate treatment group) was operated on immediately; while the second group DTG (delayed treatment group) was treated six months later, allowing us to compare the ITG with DTG. Angioplasty for CCSVI reduced lesions, improved MS symptoms and reduced relapses, when compared to those in the delayed group on the drugs alone.

    Trail Setup:

    – There is a control group for comparison, in practice it as a randomized as possible for use in surgery

    – MRI measures are rigorous, high-standard 3-tesla, comparable and indisputable as completely blind

    – Patients were evaluated by neurologists and neuroradiologists of two centers
    – Statistical analysis was done by independent statisticians and was blinded.

    Results:

    – Both groups after the PTA had a significant improvement in the MSFC score compared to previous year, with substantial maintenance of EDSS (no disease progression)

    – In the ITG during the first 6 months there were fewer relapses. The percentage has been on an annual basis of 0.16 against 0.66 of the DTG. In fact the DTG in the first six months received only drugs. After surgery, the DTG no longer had more relapses than the ITG, confirming the protective effect of PTA on relapses.

    – ITG T2 lesion load decreased while the DTG increased. After the PTA in the DTG lesion load stabilized during the second six months.

    – Complications were zero, zero thrombosis. There was 27% restenosis.

    Conclusions:

    – CCSVI is associated with MS -as the first treatment of the condition changes the clinical parameters of the second

    – The modification of parameters in a blinded MRI is totally immune from the placebo effect, then measured the improvements are real

    – The treatment is safe in safe hands and can be beneficial.

  • Re: "Did these researchers have any conflict of interest?"

    None reported. You could contact them to find out: E. Auriela (eitanman1@gmail.com), Department of neurology, Tel Aviv Sourasky Medical Center, 6 Weitzman st, Tel Aviv 64239, Israel. Tel.: + 972 52 4262721, + 972 54 3014913; fax: + 972 3 6974380.

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