Chronic cerebrospinal venous insufficiency (CCSVI or CCVI) is a term developed by Italian researcher Paolo Zamboni in 2008 to describe compromised flow of blood in the veins draining the central nervous system. Zamboni hypothesized that it played a role in the cause or development of MULTIPLE SCLEROSIS (MS). However, CCSVI may play a role also in other disease such as ASL, Parkinson, Meniere Syndrome and intractable headache. Zamboni also devised a procedure which was termed by the media as “liberation procedure” or “liberation therapy”, involving angioplasty (or stenting) of certain veins in an attempt to improve blood flow. Zamboni and colleagues claimed that in MS patients diagnosed with CCSVI, the azygos and IJV veins are stenotic (abnormally narrowed) in around 90% of cases. Most of the venous problems in MS patients have been reported to be truncular venous malformations, including azygous stenosis, defective jugular valves and jugular vein aneurysms. Problems with the innominate vein and superior vena cava have also been reported to contribute to CCSVI.
Zamboni theorized that malformed blood vessels cause increased deposition of iron in the brain, which in turn triggers autoimmunity and degeneration of the nerve’s myelin sheath. While the initial article on CCSVI claimed that abnormal venous function parameters were not seen in healthy people, others have noted that this is not the case. In the report by Zamboni none of the healthy participants met criteria for a diagnosis of CCSVI while all patients did. Afterwards, several studies of the relationship between CCSVI and MS (and also between CCSVI and other neurological and not neurological disease) have been published in the literature. The most important study on CCSVI ever published in terms of patients treated by angioplasty cames from Rome by Brain Flow Team, a medical and surgical group led by Prof. Tommaso Lupattelli. With their important study, Brain Flow Team proved that CCSVI treatment is extremely safe in expert hands (Journal Vascular Surgery http://www.jvascsurg.org/article/S0741-5214(13)01144-0/abstract). After treatment, patients with CCSVI may experience, depending on the underlying disease, a considerable relief of their symptoms. Moreover angioplasty of CCSVI may slow or even stop the progression of the underlying disease , particularly in multiple sclerosis patients.
Up to now, Brain Flow Team is worldwide considered the Team with the highest number of patients treated by angioplasty.