Liberation CCSVI Surgery - An Introduction

By Tracey Holgado
CCSVI is formally known as Chronic Cerebrospinal Venous Insufficiency. This condition involves the improper drainage of blood from the brain due to the constricted condition of the drainage veins from the central nervous system.

The constriction is often attributed to blockages in the vascular network coming from the brain. Due to the pliant nature of the vein, it is much easier to have stenosis to occur. In order to correct this, CCSVI Liberation Surgery is recommended as the vascular intervention intends to free the flow of blood from the brain.

CCSVI Liberation Surgery is designed to remove the blockages from the venal system. The accumulation of waste tainted blood in the brain leaves iron deposits in the cells that lead to cell degeneration. Because these are brain cells, brain functioning becomes severely affected.

CCSVI Liberation Surgery uses balloon angioplasty to increase blood from from the brain. An incision is done in the neck area, then a tube is inserted into the identified area of stenosis. At the tip of the tube is a balloon and once very near the blockage, is inflated gradually until the blockage is removed thus liberating the flow of blood from the brain.

This procedure may take several hours depending upon the number of stenoses present, and the level of difficulty in reaching and freeing them. Patients must lay flat for 7 to 9 hours after surgery so that their veins are not taxed immediately after the procedure. Patients generally do not need to be hospitalized for an extended amount of time.

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CCSVI Filtering - two techniques Most Popular

By Tracey Holgado
Chronic Cerebrospinal Venous Insufficiency or CCSVI is a condition wherein there is a blockage in the internal jugular or azygous veins that result in the inadequate blood flow from the brain. The insufficient blood flow from the brain causes hypoxia leading to brain deterioration and long term damage. Often, this condition is attributed to Multiple Sclerosis through the work of Dr Paulo Zamboni.

CCSVI screening is thus important to prevent the degenerative effect of CCSVI. This type of procedure is non-invasive and repeatable. Here are the ways that CCSVI screening is done.

Magnetic Resonance Venography.

This is most often called MRV and is a specialized kind to the generic Magnetic Resonance Imaging or MRI. The procedure entails the bombardment of magnetic fields unto the body to create a map of both the interior and exterior of the individual. Since each part of the body has a different chemical composition, the particular organ registers a different reading and thus a different image is registered. In MRV, a specialized machine bombards the vascular system and the reflection of the magnetic fields determines the reading registered. If the vein is normal, including the blood flow, then particular images would result. If there is a blockage or any damage causing backflow, then the composition would be registered by the machine. The key thing to remember in doing this kind of CCSVI screening is that the proper placement of the body part as well as the proper frequency of the magnetic field should be done to get the proper reading.

ECD-TCCS.

This is two-fold sonographic test conducted for CCSVI screening. The first test is the Echo-Color-Doppler scan where a specialized sonogram is run through the neck area where the internal jugular and the azygous veins are located. As the sonogram runs, an image is produced of the condition and activity of the veins to see if there is any blockage that is present. The second part of the test is the Transcranial Color Sonography wherein the brain area, particularly the connective area between the veins and the brain are monitored using sound waves to see the activity of the blood. These CCSVI screening tests would provide the doctor a full picture of the blood flow towards the brain. In these CCSVI screening tests, there is also an ability to determine the presence of blockages or damage to the veins and determine which parts of the brain receive little or no blood at all.

In CCSVI screening, it is important to determine if there is damage or blockage in the important veins coming from the brain. The more expensive test, the MRV is very particular but is more effective in determining blood velocity and flow. Also, a full map can be made of the vascular system of the individual and eventually determine if the condition is present. On the other hand, the ECD-TCCS is a cheaper alternative of CCSVI screening but two different systems need to be integrated in order to get a full picture of the venal condition. In the end, both CCSVI screening tests can determine if there is a need for endovascular surgery in order to correct the condition and thus prevent deterioration of the brain for the individual.

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Treat CCSVI Exemption Rules

By Tracey Holgado
Chronic Cerebrospinal Venous Insufficiency or CCSVI is the condition wherein constricted or blocked veins are unable to drain waste rich blood from the brain. This is a condition first formally ascribed by Dr. Paolo Zamboni in relation to his work with Multiple Sclerosis patients.

His observations showed that there is a correlation between CCSVI and other neurological diseases because of the long-term effects of hypoxia as well as the increased iron deposits in the brain. He postulated that CCSVI is a condition that can be reversed through vascular intervention, thus providing the appropriate volume and velocity of blood to the brain and at the same time remove the build up of iron in the brain matter.

In the earlier days of CCSVI, the common procedure to treat it was to catheterization. In this technique, a catheter was inserted into the area where the blockage or valve problem is present in order to correct the problem. The more complicated way was to create a diversionary vein in order to bypass the problem area.

Now, as newer technologies emerge, CCSVI intervention techniques also develop. There are two current standard methodologies of vascular intervention for CCSVI. The first one is through the use of balloon angioplasty techniques to dislodge plaque or other material blocking the proper flow of blood to the central nervous system. In this procedure, a sheath is inserted near the affected area where a tube with an uninflated balloon at the end. At the right point, the balloon would be inflated to expand the vein slowly and thus loosen the blockage, letting the normal velocity of blood flow wash away the blockage.

The second new technique in treating CCSVI is through the insertion of stents in the collapsed or problematic area. After identifying the part of the vein with a problem valve or blockage, the doctor then inserts a tube into the venal system and through that tube insert the stent in order to return the vein to normal functioning capacity. A stent by the way is medicated tubing artificially designed to perform like a regular vein in the human body. It has a valve to prevent backflow and specially treated to prevent rejection by the body when inserted into the body. By putting the stent in place, the vein's blockage or backflow problems are thus removed. Currently, only balloon angioplasty is recommended for treating CCSVI. Beware of health providers who currently use stents in their CCSVI programs.

After surgery, CCSVI patients are allowed to heal under observation as the main problem is that bleeding may occur because of the intervention performed. These individuals need a time and place that is serene and peaceful so that full recuperation from the procedure to correct CCSVI can be achieved.

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As for the treatment of chronic venous insufficiency MS CSF

By Tracey Holgado
What is CCSVI?

CCSVI or chronic cerebrospinal venous insufficiency is a condition wherein blood is not properly drained from the brain. The cause of this is believed to be the

narrowing of the lumen of the veins in the brain and the spinal cord. The narrowing causes obstruction which leads to an abnormal blood flow. The partial blockage caused deoxygenated blood to stay longer than expected within the brain or backs up into the brain. When the deoxygenated blood will reflux back to the brain, it will cause hypoxia, inflammation and iron deposition on brain tissues.

Are CCSVI and Multiple Sclerosis related?

In 2009, a study has been conducted by Dr. Paolo Zamboni and others regarding multiple sclerosis. The results have shown that 100% of the MS cases have abnormal venous flow. The venous drainage of both the brain and the spinal cord has been examined using the ultrasound technique. It has also been noted that people with MS experience different venous obstruction at various stages of the said disease. However, this theory has not been entirely proven as true. The evidence regarding the relationship of CCSVI and MS are still not enough to come to a conclusion. But some MS cases may have occurred due to the impaired venous drainage within the central nervous system. Research regarding the issue is still going on.

What is the treatment for CCSVI?

Surgical procedure is the best treatment for CCSVI. A modified balloon angioplasty can be performed. Dr. Paolo Zamboni calls this as the "Liberation Procedure". The balloon is used to dilate the obstructed blood vessels within the brain. The Liberation Procedure appears to be effective in decreasing the disease severity and the relapse rates.

Another group of surgeons at Stanford University believes that opening up the veins using stents will be effective. This is a more aggressive procedure compared to the Liberation Procedure. Stenting is rarely tried within the veins, especially within the veins of the brain and the spinal cord. Stents are mostly used within arteries.

Both procedures have promising results. However, until this research will be replicated by various independent researchers, conclusions cannot yet be drawn. If this CCSVI theory will eventually become a fact, the surgeries will be improved thus decreasing the risk involved between these surgical procedures. Although these surgeries have not been proven to be the cure, these may relieve the symptoms of multiple sclerosis. But before undergoing such procedures, it is important that you consult your doctors first.

Liberation Procedure Recovery

The liberation procedure is a less invasive procedure. The patient will stay in the hospital in about 5 days postoperatively for monitoring. The recovery for the Liberation Procedure is simple and fast. Bruising is normal after the procedure. Medications will be prescribed and the patient will be instructed regarding wound care.

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General knowledge in multiple sclerosi

By Ralph J. Greene
Self-awareness on multiple sclerosis should be within our grasp and knowledge. This disease is one of the major contributor for disability. Let us dig in to the details and widen out our perspective on this devastating disease. Multiple sclerosis is a disease that targets or influences the brain and spinal cord.

The outcome would be the loss of balance, sensation, vision, and muscle control. This serious disease could impair you for the rest of your life. The nervous system is being destroyed by the body's own immune system because it mistakes the normal tissues as foreign substance to the body. It's like being cook on your own oil. With the nerves being attack, transmitting of impulses from the brain to other parts of the body would be ruined. This disrupts most function of the body. Multiple Sclerosis is hard to characterize because it is very unpredictable. It would depend on what area of the brain is affected. The probability of getting two people with the same multiple sclerosis behavior is very slim because of its uniqueness for each individual.

The cause of this disease is still unknown but some research points it to genetics, environment or a possible viral infection. Enumerated below are the most common symptoms that a person may experience.

* Visual problems - Blurry vision, double vision, partial blindness and uncoordinated eye movement.
* Sensory Nerves - burning feeling, diminish sense of touch, numbness.
* Intestinal - Constipation and irregular Bowel Movement
* Muscle coordination and other symptoms- Vertigo, difficulty maintaining balance, muscle pains, fatigue, tremor, awkward movements, unsteadiness and dizziness.
* Mental impairment and Mood sway - loss of memory, poor judgment, depression and loss of ability to control emotion.

There is still no uniform treatment for multiple sclerosis. This is because of its erratic behavior. Inducing the patient with corticosteroids help in suppressing the immune system but it's not given for a long period because of the side effects. Without your immune system, you are very susceptible to other diseases. Other medications are also given to relieve some symptoms.

If the disease is not that severe, the patient can still maintain a dynamic lifestyle. They could still perform exercise such as swimming, running and walking. This could help them maintain their health. It's better if they are engaged in activities to prevent weakness for their body. They need to do it by themselves to increase their self-esteem. This could also prevent depression and self-pity. Maintaining and keeping a healthy lifestyle could slow the progression of this disease. They should have regular intake of vitamins and supplements to support their health. It is also necessary to avoid high temperatures since heat could aggravate the condition. People who have suffered disability would need a therapist for their rehabilitation. Family and friends should be there to support them. People with multiple sclerosis should be handled with care and love. Without this strength booster, succumbing to severe depression could ruin their life. It is best to make them feel wanted and normal.

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Women and some Sclerosis

By Kim Nelson
Multiple Sclerosis is a serious infliction, and there is still a lot that scientists don't know about the disease. What we do know this disease is that affects the central nervous system. When a patient has MS, their body attacks myelin levels. Myelin is a chemical that insulates the nerves. When this chemical is depleted,

there is no insulation for the nervous system, which causes immense pain. Over time, MS can cause fatigue, vision loss, and interference with general everyday functions.

Women are more likely to be diagnosed with this neurology disease than men. In fact, women are twice as likely to be diagnosed with MS than men. Genetics are largely thought to be a factor in who is affected by multiple sclerosis, and women with MS seem to be more likely to have a gene variation that causes inflammation and damage to tissue. This gene variation is thought to be less likely in men then in women. It has also been studied whether or not the combination of smoking and oral contraception use can cause flair ups. No matter what the cause, it is clear that more women are being affected by MS, and at an alarming rate. Women may first experience a tingling sensation in their limbs, and general fatigue. In many cases, women are diagnosed with Multiple Sclerosis soon after delivering a child, and it is thought that an increase in hormones causes symptoms of the disease to be more noticeable. Some sexual side effects are also thought to be the result of the disease.

If you, or a woman in your life has been diagnosed with MS, this is a sensitive time for everyone involved. Thankfully, there are treatment options specifically geared towards women battling this disease as well as help from many non profit groups. Sensitive, holistic care is available for women and men who need a helping hand dealing with the physical and emotional effects of this life altering disease.

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A new treatment for multiple sclerosis - is this new Cure?

By Kath Ibbetson
On September 22nd 2010,the US Food and Drug Administration (FDA) announced approval of fingolimod (Gilenya, Novartis), the first of the long-anticipated oral treatments for multiple sclerosis (MS). Multiple sclerosis is a chronic, debilitating autoimmune disease that affects the brain and spinal cord of 2.5 million people worldwide.

Fingolimod (also known as FTY720, brand name Gilenya) is a new oral treatment currently being tested in phase III clinical trials for relapsing remitting and primary progressive multiple sclerosis (MS). It is common practice that certain Phase III trials will continue while the regulatory submission is pending at the appropriate regulatory agency. Other phase 3 clinical trials of fingolimod/Gilenya, including one involving people with primary progressive MS, are still under way, as are extension studies involving those who've completed other fingolimod trials.

In these clinical trials the end points included the annualized relapse rate (ARR) and the time to disability progression. Patients receiving continuous fingolimod treatment had sustained low annualized relapse rates of 0.20-0.21, and 68-73% remained relapse-free at 36 months. Patients on Gilenya 0.5mg for two years had a ARR at year one of 0.16 and at year two of 0.18. These patients also retained a significant reduction in relapses and MRI brain lesions over 2 years As a result, fingolimod/Gilenya is approved to reduce relapses and delay disability progression in patients with relapsing forms of MS but at this stage long-term safety is unknown. Post marketing studies (phase IV clinical trials) should provide additional data on its safety and efficacy.

How does fingolimod work?

MS causes the body to direct antibodies and white blood cells against proteins in the myelin sheath that surrounds the nerves in the brain and spinal cord thus causing the breakdown of myelin and interruption to nerve signals. Fingolimod acts on certain types of white blood cells (lymphocytes) which are involved in this immune attack. It attaches to special locations (or receptors) on the surface of lymphocytes, called sphingosine-1-phosphate receptors (S1P-R). This causes a large proportion of the lymphocytes to be retained in the lymph nodes (part of the body's immune system) and so reduces the number of lymphocytes circulating in the blood. As the lymphocytes are held in the lymph nodes then less reach the central nervous system so there is less immune attack on nerve cells in the brain and spinal cord.[1] There is also evidence that fingolimod may have a direct effect on nerve cell damage and enhance remyelination by acting on sphingosine receptors in the central nervous system.[2, 3]

How is fingolimod given?

Fingolimod is administered in the form of a 0.5 mg oral capsule. Patients usually take 0.5 mg once per day although in trials many were given 1.25mg per day. However, Fingolimod doses higher than 0.5 mg are associated with a greater incidence of side effects without additional benefit.

Side effects and contraindications

Generally fingolimod is well tolerated but the side effects that have occurred include: • headache • shortness of breath • upper respiratory tract infection • diarrhea and nausea. Increased levels of liver enzymes and raised blood pressure have also been observed although these are generally mild. In one of the clinical trial, two deaths resulting from herpes virus infections occurred in patients taking the higher dose of fingolimod. Other aspects of the treatments these two patients received may have contributed but, given its immunomodulatory action, a role for fingolimod cannot be ruled out. Macular oedema (swelling in the back of the eye) also occurred more frequently in the fingolimod-treated participants. In more than one trial there were cases of localised skin cancer in the fingolimod groups but these were successfully removed.

Other drugs in the pipeline

Cladribine (Merck KGaA) was also in the race for first oral agent for the treatment of MS in the United States. In August 2010, the FDA accepted the company's application and granted it priority review. Cladribine was recently approved in Russia and Australia and is under review by the European Commission and other regulatory agencies. Other oral MS treatments in development include laquinimod (Teva), teriflunomide (Sanofi-Aventis), and BG-12 (Biogen).

1 Brinkmann V, et al. FTY720: sphingosine 1-phosphate receptor-1 in the control of lymphocyte egress and endothelial barrier function. American Journal of Transplantation 2004;4:1019-1025.

2 Miron VE, et al. Cyclical and dose-dependent responses of adult human mature oligodendrocytes to fingolimod. American Journal of Pathology 2008;173:1143- 1152

3 Miron VE, et al. Fingolimod (FTY720) enhances remyelination following demyelination of organotypic cerebellar slices. American Journal Pathology 2010;176:2682-2694.

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