Robert
Zivadinov, MD, PhD, recently told a Canadian Senate
subcommittee that only patients in approved clinical trials should
receive endovascular treatment for chronic cerobrospinal venous
insufficiency.
“CCSVI intervention should be restricted to blinded,
randomized and controlled clinical trials that will establish the
safety and efficacy of these endovascular procedures,” said
Zivadinov, professor of neurology, during the Nov. 1
hearing.
The Canadian Senate Committee on Social Affairs, Science and
Technology invited Zivadinov to testify on a bill to establish a
“national strategy” for CCSVI. The condition,
characterized by impaired blood flow from the central nervous
system to the periphery, has generated interest worldwide for the
hypothesis that it may contribute to brain tissue injury in
multiple sclerosis.
Although independent studies have suggested a connection between
CCSVI and MS——including one of the largest to date
being conducted by Zivadinov and UB colleagues— none has
conclusively determined an association.
“While our
research points against CCSVI having a primary causative role in
the development of MS, we have established that there is a
higher prevalence of CCSVI in progressive MS patients,”
Zivadinov said.
“This suggests that CCSVI may contribute to, or be a
consequence of, disease progression, with important implications
for treating its symptoms.”
The director of the UB Buffalo
Neuroimaging Analysis Center, Zivadinov has published and
presented more than 25 studies on CCSVI with his colleagues.
One of these found that patients with other neurologic diseases
and healthy individuals also present with CCSVI, a finding that
Zivadinov said underscores the need for additional studies.
Until researchers can confirm the safety and efficacy of
endovascular treatments for CCSVI, he said, there is “no
role” for them, outside of approved clinical trials, in
patients with MS or other neurological conditions.
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