Chronic Cerebrospinal Venous Insufficiency (CCSVI)

Reviewed by: HU Medical Review Board | Last reviewed: April 2023

Chronic cerebrospinal venous insufficiency (CCSVI) is a condition in which the normal drainage from the brain and spinal cord by the veins is impaired, due to the veins being narrowed. As a result, the blood flow may back-up into the brain and spinal cord.1

In 2009, Dr. Paolo Zamboni from the University of Ferrara in Italy published data that supported his idea that CCSVI might contribute to the development of multiple sclerosis (MS), with the hypothesis that the impairment in blood flow might lead to the inflammation seen in MS. In Dr. Zamboni’s studies, all of the patients with MS also had CCSVI.1

Subsequent studies

Subsequent studies have failed to find a connection between CCSVI and MS. There is now a growing body of evidence that suggests CCSVI is not linked with MS.2,3

In addition, there is controversy over how CCSVI is diagnosed. The diagnostic criteria set out by Dr. Zamboni are nonspecific and may account for people being diagnosed who actually don’t have anything wrong. The criteria were not based on validated methodology, and numerous groups that used the criteria from Dr. Zamboni found no evidence of CCSVI in people with MS.4

Treating CCSVI does not affect MS

Two clinical trials have demonstrated that treating CCSVI has no effect on the progression of MS, leading more evidence to the idea that CCSVI does not cause MS. To treat CCSVI, doctors do an angioplasty procedure on the vein that drains from the head. During angioplasty, a thin tube is threaded to the vein and a balloon is inflated to push any plaque to the walls of the vein. In some cases, a metal mesh tube is put into the vein to keep it open.2,5,6

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