Wednesday February 21st 2018

Study raises complication concerns over MS treatment

New Canadian research has documented numerous complications in MS patients who have travelled abroad to undergo a controversial treatment for their illness.

Researchers at the University of Calgary followed five patients who had undergone the so-called “liberation therapy,” a treatment for MS developed by Italian researcher Paolo Zamboni. Zamboni believes the disease is caused by a narrowing of the vessels that drain blood from the brain, a condition called chronic cerebrospinal venous insufficiency, or CCSVI.

The condition allows for iron deposits to build up on the brain, Zamboni says, which leads to debilitating symptoms.

Zamboni’s research has shown some patients are relieved of their symptoms after having stents surgically implanted to open the narrowed veins. However, other studies have not found a link between CCSVI and MS and have reported that patients who are treated for CCSVI suffer from a variety of side effects and complications.

In their study, the Calgary researchers reported numerous complications in the five patients, including;
•Internal jugular vein stent thrombosis
•Cerebral sinovenous thrombosis
•Stent migration
•Cranial nerve injury
•Injury associated with venous catheterization

The researchers conclude that evidence of the risks associated with the treatment is growing just as the debate over whether CCSVI plays a role in MS continues.

“As increasing numbers of MS patients are seeking such procedures, these five cases represent the beginning of a wave of complications for which standardized care guidelines do not exist,” the authors write. “Our experience and that of our colleagues will be used to develop guidelines and strategies to monitor and manage these patients as their numbers increase.”

The findings are published in the Canadian Journal of Neurological Sciences.

The news of Zamboni’s theory sparked demands among Canadian MS patients that the treatment, dubbed the “liberation therapy,” be offered to patients in this country. In June, Health Minister Leona Aglukkaq announced that the federal government will fund clinical trials into the therapy.

In the meantime, Canadian patients have travelled overseas for treatment, which has raised fears among some doctors that the patients are not receiving adequate follow-up care.

In an editorial accompanying the Calgary study, neurologist Dr. Marcelo Kremenchutzky of the London Health Sciences Centre, points out that a lack of follow-up care means complications may go under-reported or “misclassified, so the risk/benefit profile of endovascular procedures for presumed venous stenosis in MS patients remains unknown.”

He cites data from Poland that showed a variety of complications, from gastrointestinal hemorrhage to stent migration, as well as Bulgarian data that found complications such as ruptured veins and cardiac arrhythmias.

Kremenchutzky points out that as the controversy swirls around CCSVI and the so-called “liberation therapy,” patients are still looking outside Canada for treatment while their doctors are developing methods to manage potential complications once they return home.

“While the debate continues, and science runs its course, Burton et al remind us that these procedures are not without risk,” he writes, “and that follow-up care should focus on identification of potential complications, as it is the duty of the treating physician to identify, investigate, and mitigate such risks while maximizing benefits.”

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One Comment for “Study raises complication concerns over MS treatment”

  • Sameh says:

    Complication rate is similar to any other angiographic procedure and it is the only hope for MS pateints with very high sucess rate

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