Conclusion and recommendations
“Based on these extensive, scientifically solid data obtained from investigators outside of Ferrara, we see no rationale to support CCSVI as a key pathogenetic factor in MS. Furthermore an ongoing large multi-center Italian epidemiological study recruiting more than 1000 MS patients and about 1000 healthy controls and patients with other neurodegenerative diseases, promoted by the Italian Foundation of Multiple Sclerosis and endorsed by the Italian Society of Neurology will greatly augment our scientific knowledge about the relationship between CCSVI and MS. There is the theoretical possibility that the venous drainage of autoimmune lymphocytes from the brain may cause some endothelial changes during the longstanding disease course of MS, maybe in combination with immunosuppressive therapies. Yet even if this were the case, this is insufficient to justify invasive, costly and potentially dangerous manipulations of the deep cervical venous system in MS patients. Therefore, both the EFNS and the ENS Multiple Sclerosis Scientist Panel and ECTRIMS Executive Committee emphasize the high risk and absence of a scientific basis for “liberation procedures” in MS patients. All societies are in full accord with the Multiple Sclerosis International Federation statement on CCSVI (http://www.msif.org/en/research/msif_on_ccsvi.html)".