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Before Canadian Senate, Zivadinov Urges Caution for CCSVI Treatment

Robert Zivadinov, MD, PhD

Robert Zivadinov, MD, PhD

Published November 21, 2012

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.

Lacking Conclusive Link Between MS, CCSVI

“CCSVI intervention should be restricted to blinded, randomized and controlled clinical trials that will establish the safety and efficacy of these endovascular procedures.”
Robert Zivadinov, MD, PhD
Professor of neurology

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.”

Outside of Clinical Trials, “No Role” for Intervention

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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