DIAGNOSIS & TREATMENT

CCSVI and CCSVI Procedure

Multiple Sclerosis (MS) is a chronic disease that affects the central nervous system, which consists of the spinal cord and the brain. Doctors believe that it results from an autoimmune disorder in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged.

Prof Zamboni completed a preliminary study using ultrasound and MRV (magnetic resonance venography) to examine the blood vessels leading in and out of the brain. He discovered that the majority of the patients with MS had deformed or blocked jugular and azygos veins. Consequently venous blood which should be drained from the brain flows back towards the brain. Prof Zamboni theorised that this phenomenon causes increased deposition of iron in the brain, which in turn triggers autoimmunity and degeneration of the nerve’s myelin sheath and therefore may contribute to develop MS.

This condition is called Chronic Cerebrospinal Venous Insufficiency – CCSVI.

CCSVI procedure

Balloon angioplasty has been proposed as a treatment option for CCSVI in MS. During the treatment a technique is used to mechanically widen a narrowed or obstructed vein.

Technique

An empty and collapsed balloon on a guide wire is inserted through a vessel in the groin and passed into the narrowed vein. The balloon is inflated to a fixed size to dilate or open the blood vessel for improved flow.

Once the vein is dilated and the blood flow is satisfactory, the balloon is deflated and the guide wire withdrawn. The procedure is performed under sedation.

The day before the CCSVI procedure

The surgeon may ask for blood tests or other pre-ops, like Sonography, ECG, X-ray, to be taken a few days prior to the surgery.

Quit smoking as soon as your surgery is scheduled. Inform your Doctor if you continue to smoke because it will significantly affect the healing process.

The day of the CCSVI procedure

• You will be asked to starve from all food for about 6 hours prior to the procedure but you can continue drinking water until 2 hours before.
• Do not apply body lotion, moisturiser or makeup on the day of the procedure.
• You will be asked to bring with you all the medications you are presently taking. This includes all the vitamins, herbal supplements and over-the-counters medicines you may be taking.

• You will be shaved in the groin area.

• Arrange for transportation to and from the hospital. You cannot drive after surgery until your Consultant advises. (Maltese patients only)
• You will be asked to remove any jewellery, body piercings, contact lenses and dentures before surgery. Please advise the Doctor if you have any loose teeth or bridgework.
• Remove all nail polish before surgery. If you have nail extensions you must remove the one on your index finger.
• You are kindly reminded not to bring any valuables with you.

After the CCSVI procedure you will be asked to rest for at least 4 hours or for the length of time the surgeon tells you to.

The day after the CCSVI procedure.

You will be booked for a Sonography to check the blood flow of the veins after the procedure and a meeting with the Outpatient Nurses.

Emergency number: 23291528/29

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.”
Orison Swett Marden