CCSVI saturday

Ploughman M, Harris C, Hogan SH, Murray C, Murdoch M, Austin MW, Stefanelli M. Navigating the "liberation procedure": a qualitative study of motivating and hesitating factors among people with multiple sclerosis. Patient Prefer Adherence. 2014;8:1205-13

BACKGROUND: The debate within the multiple sclerosis (MS) community initiated by the chronic cerebrospinal venous insufficiency (CCSVI) hypothesis and the subsequent liberation procedure placed some people with MS at odds with health care professionals and researchers.

OBJECTIVE: This study explored decision making regarding the controversial liberation procedure among people with MS.

SUBJECTS AND METHODS: Fifteen people with MS (procedure, n=7; no procedure, n=8) participated in audiotaped semistructured interviews exploring their thoughts and experiences related to the liberation procedure. Data were transcribed and analyzed using an iterative, consensus-based, thematic content-analysis approach.

RESULTS: Participants described an imbalance of motivating factors affirming the procedure compared to hesitating factors that provoked the participant to pause or reconsider when deciding to undergo the procedure. Collegial conversational relationships with trusted sources (eg, MS nurse, neurologist) and ability to critically analyze the CCSVI hypothesis were key hesitating factors. Fundraising, family enthusiasm, and the ease of navigation provided by medical tourism companies helped eliminate barriers to the procedure.

CONCLUSION: Knowledge of factors that helped to popularize the liberation procedure in Canada may inform shared decision making concerning this and future controversies in MS.

With a sample size so small it may be difficult to make any useful

Jandaghi AB, Amanian D, Roudbari SA, Kanafi AR, Pourghorban R.Evaluation of haemodynamic properties of cerebral venous drainage in patients with multiple sclerosis: a case-control study.
Pol J Radiol. 2014 Sep 19;79:323-7. doi: 10.12659/PJR.890690. eCollection 2014.

BACKGROUND: The purpose of this study was to compare patients with multiple sclerosis and healthy control subjects as regards haemodynamics of cerebral venous drainage.

MATERIAL/METHODS: Between December 2012 and May 2013, 44 consecutive patients with multiple sclerosis and 44 age- and sex-matched healthy subjects underwent the B-mode, color Doppler, and duplex Doppler evaluations of the internal jugular vein (IJV) and vertebral vein. The following four parameters were investigated: IJV stenosis, reversal of postural control of the cerebral venous outflow pathways, absence of detectable blood flow in the IJVs and/or vertebral veins, and reflux in the IJVs and/or vertebral veins in the sitting or supine position.

RESULTS: In the study group, IJV stenosis, postural control reversal of the cerebral venous outflow pathways, and absence of flow in the IJVs and/or vertebral veins were found in 3 (6.8%), 2 (4.5%), and 3 (6.8%) patients, respectively. In the control group, IJV stenosis (P=0.12), postural control reversal of the cerebral venous outflow pathways (P=0.50), and absence of flow (P=0.12) were not detected. Abnormal reflux was found neither inmultiple sclerosis patients nor in healthy subjects.

CONCLUSIONS: No significant difference in the cerebral venous drainage through the IJV or vertebral vein was found between patients with multiple sclerosis and healthy subjects within any of the investigated ultrasonographic parameters.

Nothing of interest. Maybe it is time to kick these posts into touch? 

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