Chronic Cerebrospinal Venous Insufficiency (CCSVI) Liberation Treatment

Chronic-Cerebrospinal-Venous-Insufficiency-(CCSVI)-Liberation
 
Chronic Cerebrospinal Venous Insufficiency (CCSVI) Liberation Treatment

A chronic cerebrospinal venous insufficiency (or CCSVI) is a condition that results in draining of blood from the veins of the central nervous system. This condition is known to cause development of multiple sclerosis.

A CCSVI Liberation treatment attempts to treat this lack of blood flow in the veins using stent techniques in order to improve the flow of blood in the central nervous system.

What are the causes of Chronic Cerebrospinal Venous Insufficiency (CCSVI)?

Scientists and the medical fraternity have not been able to pinpoint the exact trigger for causing chronic cerebrospinal venous insufficiency (CCSVI) although a few risk factors have been positively identified that are known to contribute towards causing CCSVI.

These are the few risk factors known for giving rise to CCSVI:

Venous malformations

Most veins in the multiple sclerosis patient suffer from truncular venous malformations and problems with innominate vein and superior vena cava have also been associated with CCSVI.

Iron deposits

Neuro-imaging studies have shown ample evidence of a relationship between venous pressure and iron deposits in patients suffering from multiple sclerosis.

Genetics

Several detailed scientific studies have related certain specific genes as being the trigger for causing CCSVI in many patients.

How is Chronic Cerebrospinal Venous Insufficiency (CCSVI) diagnosed?

The doctor/specialist will use different diagnostic techniques according to their individual expertise. The doctors look for specific conditions being caused by the suspected CCSVI for diagnosing it positively, such as:

  • Reflux in the jugular and vertebral veins
  • Reflux in the deep cerebral veins
  • Stenosis evidence found in the internal jugular vein
  • No blood flow in the jugular vein or vertebral vein on Doppler ultrasound 

How is Chronic Cerebrospinal Venous Insufficiency (CCSVI) treated?

A condition of CCSVI, when diagnosed positively by your doctor/physician, requires a surgical procedure of treatment. CCSVI treatment may include either stent placement or balloon angioplasty to open the blocked veins of the spinal cord and brain and allow normal blood flow through them.

CCSVI treatment is performed using specialized minimally invasive surgical techniques that use catheter-based endovascular procedure. A trained endovascular surgeon will perform the surgery for treating CCSVI along with a team of multi-disciplinary team of medical specialists.

The surgery begins with the administering of local anesthesia to the groin region for inserting the catheter to access the veins in the back without disturbing the surrounding healthy blood vessels.

Once the skin and the tissue of the groin region are anesthetized the surgeon will make a small puncture in the femoral vein with a small needle. The surgeon will then insert a guide-wire through the needle into the vein. After the needle is removed the surgeon will insert a thin and tubular catheter over the wire. The catheter is then guided upwards through the vein into the right ventricle of the heart to the right atrium of the heart and on to the superior vena cava vein. From this point the surgeon is able to use the catheter to access the veins that drain the central nervous system.

The surgeon uses a special dye (radio-opaque contrast agent) injected in the blood vessel near the obstructed/narrowed vein to observe the blood flow through these veins in real time using advanced x-ray imaging techniques such as fluoroscopy. This process is known as catheter venography.

At times certain surgeons might also use an intravascular ultrasound (IVUS) device to identify the stenosis positively. This method is especially useful in identifying other venous problems such as septum sot valve abnormalities.

There are two main CCSVI treatment types:

Balloon angioplasty – In this procedure the vein is opened (or enlarged) by inflating a cylindrical-shaped surgical balloon attached to a catheter in the obstructed vein. The balloon is fixed at the end of a catheter in a deflated condition. This catheter is guided, using advanced imaging techniques in real-time, during the procedure to the spot if stenosis and is inflated using air. The surgeon will often inflate and deflate the balloon a few times to ensure that the desired degree of width is achieved in the affected vein. Once all the blockages are removed the balloon along with the catheter are removed through the vein and out of the body.

Stenting – This procedure is similar to a balloon angioplasty but uses a slightly different type of catheter, which is known as a ‘stent-delivery catheter’. A stent is actually a medical-grade artificial metal-mesh in a tube-shape which is attached to the end of the catheter. The catheter is placed near the blockage in the vein using imaging techniques similar to those used for a balloon angioplasty. Once the catheter carrying the metal-mesh reaches the point of blockage in the vein the metal-mesh is unfolded and provides a support to keep the vein unblocked and allow normal blood flow through the vein. This method is considered to be a more permanent solution than a balloon angioplasty.

What are the advantages of Chronic Cerebrospinal Venous Insufficiency (CCSVI) treatment?

Both the techniques for performing a CCSVI treatment are advantageous mainly due to their minimally invasive nature. This allows for less pain during surgery, faster recovery after surgery as well as less discomfort and scarring after the procedure.

The balloon angioplasty is found to be effective in keeping the unblocked veins open for a sufficiently longer period of time and is a faster procedure than a conventional open-type angioplasty. The stenting method for treating CCSVI is more advantageous than other treatment methods as it is considered to be a more efficient and permanent solution for resuming blood flow in a previously-blocked vein of the central nervous system.

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