Apollo Hospitals, India, with its team of expert vascular surgeons now offers the Endovascular [Liberation] treatment for CCVSI , advocated by the Italian surgeon Dr Paulo Zamboni. Apollo Hospitals has taken this procedure up as a clinical study project and has already performed this procedure on several patients from Canada and the USA. The demand and enquiry for this procedure from Multiple sclerosis patients all over the world is steadily increasing.
What is Multiple Sclerosis?
Multiple Sclerosis is a degenerative disorder affecting the brain and spinal cord. In this condition, the myelin sheath which provides a covering for the nerves gets inflamed and disappears over a period of time. As a consequence the conduction of electrical impulses across these nerve bundles either slows down or completely stops. As more and more nerves are affected, a broad range of signs and symptoms occur, such as loss of balance, impaired speech, extreme fatigue, and paralysis .This disease is common amongst Caucasians. In the US approximately 450000 people suffer from Multiple Sclerosis, while in Canada approximately 750000 patients suffer from this chronic debilitating condition. The exact cause of the condition is unknown. In the last two decades the research has been focused on the immunological and genetic aspects of the condition. However in the last few years more work is being done on the vascular causes of the condition too.
What is CCSVI?
Recently, a discovery made by Dr. Paolo Zamboni in Italy has provided a new way of looking at the disease. Venous outflow obstruction either in the jugular or azygos system of veins [the veins that drain the central nervous system including the brain] is believed to be a reason for developing Multiple Sclerosis. This obstruction is called CCSVI [Chronic cerebro spinal venous insufficiency]. In CCSVI, the substitute venous circuits which form to bypass the blocked veins cause reduced resistance to drainage in order to avoid intracranial hypertension. But this also leads on to insufficient venous drainage as made out by increased transit time, as seen by perfusion studies.
How is this connected to Multiple Sclerosis?
It is believed that due to CCVSI, iron builds up in the brain, blocking and damaging crucial blood vessels. This causes the vessels to rupture, which allows both the iron and immune cells from the bloodstream, to cross the blood-brain barrier into the cerebro-spinal fluid. Once the immune cells have direct access to the immune system, they begin to attack the myelin sheathing of the cerebral nerves, and result in the development of Multiple Sclerosis.
It is now thought that Endovascular treatment [Liberation treatment] to clear the venous blockage may be effective in managing the symptoms of Multiple sclerosis and could be beneficial to patients of Multiple Sclerosis.
Simply put, this treatment involves the following steps.
The treatment begins by performing a preliminary venogram to confirm narrowing of the jugular or azygos veins. This is done under local anesthesia in the Fluoroscopy suite. Through a groin vein, a guide wire is passed initially and a catheter is passed over it. Pressure recordings are taken at various levels and the dye is injected through the catheter inside the jugular and azygos veins. Once the presence of narrowing is confirmed, a balloon catheter is placed at the diseased segment and the balloon is inflated for a period of 1to 2 minutes. The final venogram is performed to confirm the clearance of the narrowing.This procedure takes approximately one hour and it is safe.
Apollo Hospitals, India, with its team of expert vascular surgeons now offers this procedure to eligible Multiple sclerosis patients from all over the world. Apollo Hospitals has taken this procedure up as a clinical study and has already performed this procedure on well over 14 patients from Canada and the USA. The demand and enquiry for this procedure from Multiple sclerosis patients all over the world is steadily increasing.
Being the most renowned hospital group in Asia, with extensive experience in treating patients from over 50 countries, and with the largest number of JCI accredited hospitals in the region, it is no surprise that patients of Multiple sclerosis from all over the world are looking to the Apollo Hospitals group to offer them this new procedure that may eventually provide them relief from this chronic and debilitating disease.
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