Written By Julie Stachowiak, Ph.D., of about.com
March 16, 2010
Let me start by mentioning that these procedures involved placing stents in the jugular veins, NOT the procedures that were performed using balloon angioplasty only.
Many of us living with multiple sclerosis (MS) have been following the stories around chronic cerebrospinal insufficiency (CCSVI), a new theory which purports that the root cause of MS may lie in veins that are narrowed, blocked or deformed not allowing blood to drain from the brain in a normal flow. Since this seems to be a mechanical problem, it would make sense that by fixing the veins to improve the flow would be a logical step.
Sure enough, some doctors have been doing just this. The doctor who "discovered" the CCSVI-MS link, Dr. Paulo Zamboni, has performed an operation that he calls the "Liberation Treatment" on several patients in Italy. As far as I can tell, all of the procedures performed by Dr. Zamboni have involved balloon angioplasty (aka percutaneous transluminal angioplasty) only and not stents.
However, several people in the US had operations performed at Stanford University to address their CCSVI situation. Many of these procedures involved placing a stent - a small wire mesh tube designed to keep the veins open and blood flowing - in their jugular veins.
Following their procedures, one patient died from a brain hemorrhage (in August 2009) and another had to have emergency open heart surgery after a stent dislodged and traveled to the right ventricle of the heart (in November 2009). Both procedures were performed by Dr. Dake at Stanford.
As of this moment, CCSVI treatment at Stanford has been halted. There has been outcry about this, with many people saying that the treatment should continue.
Clearly, a stent migrating to the heart is pretty much irrefutably linked to placing the stent in the body in the first place. Stents are really intended for arteries, which carry blood away from the heart and get wider further away from the heart. Veins carry blood to the heart and get wider toward the heart, meaning that stents that get dislodged can travel into the heart (as this one did).
However, the death due to cerebral hemorrhage is not as clearly linked to the procedure in the minds of some people. In fact, her family members and many friends are adamant that the procedure itself had nothing to do with Holly's death. They claim that her death was instead a result of an adverse reaction to the prescribed blood thinners, due to a genetic condition.
What do you think? Should the procedures be halted until more research has been done or should people continue to be able to decide to get this procedure? Share your opinion in the comment section below.
3 comments:
I consider the doctors and patients who have performed/undergone this treatment to be heroes and pioneers. So long as everyone is properly informed of the potential downsides and and are still willing to proceed, I don't think the angioplasty procedures should be stopped. Two primary reasons come to mind. One, the patients probably have as an alternative a worsening MS condition, with time not on their side. Two, doctors are in effect developing data that will enhance our understanding of the potential and downsides of this procedure. They may also in the process shed light on the nature, causes, and treatment of MS. With respect to the stenting, that may be a more complex issue requiring more study before proceeding.
Judy
Thank you for your comment Judy.
Please send an email to me, at stuart@msviewsandnews.org as I want to learn more about your writing
Zamboni did place one stent in a rather stubborn azygos vein.
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