- Introduction

Multiple Sclerosis (MS) is a chronic inflammatory and demyelinating disease of the Central Nervous System (CNS). It is of unknown origin and considered autoimmune. Evolution can be relapsing-remitting or progressive.

A new theory emerged recently by Dr. Paolo Zamboni from University of Ferrara, Italy.

During an international conference in Bologna entitled “Venous functions and Multiple Sclerosis (MS) he announced a surprising discover: CCSVI or chronic cerebrospinal venous insufficiency. In a practical way this shows that with a minimally invasive procedure we can obtain a clinical improvement in patients with MS, especially those who have a RR (relapsing remitting). This theory also shows that MS is considered a vascular disease instead of a autoimmune disease as was accepted.

This insufficiency is characterized by multiple stenosis (reduction of a vessel caliber) of the main drainage pathways of venous blood, especially the Azygos Vein (AV) and Internal Jugular Veins (IJV). It was also observed in recent studies the existence of compensatory collateral venous circulation after evaluation of these veins. The CCSVI is closely related to MS. With the treatment we observe a venous drainage improvement, a decreased cerebral venous congestion and the patients become symptomatically better.

There are some articles in Scientific literature saying that stenosis in the jugular veins and azygos vein exist in patients with MS and those stenosis are related to cefaloraquidian hypertension.

There are also some publications that show the clinical improvement after the endovascular treatment of those stenosis, by angioplasty or stenting.

At Saint Louis Hospital in Lisbon, MS is treated by angioplasty and stenting. The procedures should not be considered a treatment because he medium and long term results are not known, but an investigation. Prof. Armando Sena and Dr. Rui Pedrosa, neurologists with large experience in MS, will collaborate in the investigation by periodical evaluation of the patients. Their participation does not mean their approval or incentive for the performance of the intervention but only their availability for the investigation of eventual benefits. In the team there is Professor Martins Pisco pioneer of Interventional Radiology in Portugal and other Interventional Radiologist Dra. Marisa Duarte and Dr. Tiago Bilhim, assistants Professors at Faculty of Medical Sciences, and By Drs. Hugo Rio Tinto and Lúcia Fernandes.

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