Multiple Sclerosis Center, Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine, Detroit, MI 48323, USA.
Ann Neurol. 2010 Mar;67(3):286-90. doi: 10.1002/ana.22001.
A chronic state of impaired venous drainage from the central nervous system, termed chronic cerebrospinal venous insufficiency (CCSVI), is claimed to be a pathologic phenomenon exclusively seen in multiple sclerosis (MS). This has invigorated the causal debate of MS and generated immense interest in the patient and scientific communities. A potential shift in the treatment paradigm of MS involving endovascular balloon angioplasty or venous stent placement has been proposed as well as conducted in small patient series. In some cases, it may have resulted in serious injury. In this Point of View, we discuss the recent investigations that led to the description of CCSVI as well as the conceptual and technical shortcomings that challenge the potential relationship of this phenomenon to MS. The need for conducting carefully designed and rigorously controlled studies to investigate CCVSI has been recognized by the scientific bodies engaged in MS research. Several scientific endeavors examining the presence of CCSVI in MS are being undertaken. At present, invasive and potentially dangerous endovascular procedures as therapy for patients with MS should be discouraged until such studies have been completed, analyzed, and debated in the scientific arena.
一种中枢神经系统静脉回流受损的慢性状态，称为慢性脑脊髓静脉功能不全（CCSVI），据称这是一种仅在多发性硬化症（MS）中见到的病理现象。这激发了 MS 的因果关系辩论，并在患者和科学界引起了极大的兴趣。有人提出了一种潜在的 MS 治疗模式转变，涉及血管内球囊血管成形术或静脉支架置入术，并在小患者系列中进行了研究。在某些情况下，它可能会导致严重的伤害。在本观点中，我们讨论了导致描述 CCSVI 的最近研究，以及挑战这种现象与 MS 之间潜在关系的概念和技术缺陷。从事 MS 研究的科学机构已经认识到需要进行精心设计和严格控制的研究来调查 CCVSI。目前，在这些研究完成、分析并在科学领域进行辩论之前，应劝阻对 MS 患者进行有创和潜在危险的血管内手术作为治疗方法。
