ReviewJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2013
What went wrong? The flawed concept of cerebrospinal venous insufficiency.
Review in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 53 citations in OpenAlex.
- Safety and efficacy of venoplasty in MS: A randomized, double-blind, sham-controlled phase II trial.Neurology · 2018Trial
- Concomitant analysis of arterial, venous, and CSF flows using phase-contrast MRI: a quantitative comparison between MS patients and healthy controls.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2013Trial
- Vascular multiple sclerosis: addressing the pathogenesis, genetics, pro-angiogenic factors, and vascular abnormalities, along with the role of vascular intervention.Annals of medicine and surgery (2012) · 2023Review
- No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years.BMC neurology · 2019Observational
- Four-dimensional flow magnetic resonance imaging and ultrasound assessment of cerebrospinal venous flow in multiple sclerosis patients and controls.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2017Article
- The Stress and Vascular Catastrophes in Newborn Rats: Mechanisms Preceding and Accompanying the Brain Hemorrhages.Frontiers in physiology · 2016Article
- Optical monitoring of stress-related changes in the brain tissues and vessels associated with hemorrhagic stroke in newborn rats.Biomedical optics express · 2015Article
- "Liberation treatment" for chronic cerebrospinal venous insufficiency in multiple sclerosis: the truth will set you free.Brain and behavior · 2015Review
- Chronic cerebrospinal venous insufficiency in patients with Ménière's disease.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2015Article
- Ultrahigh field MRI in clinical neuroimmunology: a potential contribution to improved diagnostics and personalised disease management.The EPMA journal · 2015Review
- Validity of the diagnostic criteria for chronic cerebrospinal venous insufficiency and association with multiple sclerosis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Article
- Phlebographic study does not show differences between patients with MS and control subjects.AJNR. American journal of neuroradiology · 2014Article
- Hemoglobin as a source of iron overload in multiple sclerosis: does multiple sclerosis share risk factors with vascular disorders?Cellular and molecular life sciences : CMLS · 2014Article
- Cerebral veins-why functional MR imaging is worth the trouble.AJNR. American journal of neuroradiology · 2014Article
- [Ultrahigh field MRI in context of neurological diseases].Der Nervenarzt · 2014Review
- Ultrasonographic evaluation of cerebral arterial and venous haemodynamics in multiple sclerosis: a case-control study.PloS one · 2014Article
- Navigating the "liberation procedure": a qualitative study of motivating and hesitating factors among people with multiple sclerosis.Patient preference and adherence · 2014Article
- Is there a link between the extracranial venous system and central nervous system pathology?BMC medicine · 2013Article
- Potential involvement of the extracranial venous system in central nervous system disorders and aging.BMC medicine · 2013Review
- Multiple sclerosis: CCSVI deconstructed and discarded.Nature reviews. Neurology · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In 2006, Zamboni reintroduced the concept that chronic impaired venous outflow of the central nervous system is associated with multiple sclerosis (MS), coining the term of chronic cerebrospinal venous insufficiency ('CCSVI'). The diagnosis of 'CCSVI' is based on sonographic criteria, which he found exclusively fulfilled in MS. The concept proposes that chronic venous outflow failure is associated with venous reflux and congestion and leads to iron deposition, thereby inducing neuroinflammation and degeneration. The revival of this concept has generated major interest in media and patient groups, mainly driven by the hope that endovascular treatment of 'CCSVI' could alleviate MS. Many investigators tried to replicate Zamboni's results with duplex sonography, magnetic resonance imaging, and catheter angiography. The data obtained here do generally not support the 'CCSVI' concept. Moreover, there are no methodologically adequate studies to prove or disprove beneficial effects of endovascular treatment in MS. This review not only gives a comprehensive overview of the methodological flaws and pathophysiologic implausibility of the 'CCSVI' concept, but also summarizes the multimodality diagnostic validation studies and open-label trials of endovascular treatment. In our view, there is currently no basis to diagnose or treat 'CCSVI' in the care of MS patients, outside of the setting of scientific research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.