CCSVI and MS: A statement from the European Society of neurosonology and cerebral hemodynamics

Claudio Baracchini, Jose M. Valdueza, Massimo Del Sette, Galina Baltgaile, Eva Bartels, Natan M. Bornstein, Juergen Klingelhoefer, Carlos Molina, Kurt Niederkorn, Mario Siebler, Matthias Sturzenegger, Bernd E. Ringelstein, David Russell, Laszlo Csiba

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)

Abstract

To systematically review the ultrasonographic criteria proposed for the diagnosis of chronic cerebrospinal venous insufficiency (CCSVI). The authors analyzed the five ultrasonographic criteria, four extracranial and one intracranial, suggested for the diagnosis of CCSVI in multiple sclerosis (MS), together with the references from which these criteria were derived and the main studies that explored the physiology of cerebrospinal drainage. The proposed CCSVI criteria are questionable due to both methodological and technical errors: criteria 1 and 3 are based on a scientifically incorrect application of data obtained in a different setting; criteria 2 and 4 have never been validated before; criterion 2 is technically incorrect; criteria 3 and 5 are susceptible to so many external factors that it is difficult to state whether the data collected are pathological or a variation from the normal. It is also unclear how it was decided that two or more of these five ultrasound criteria may be used to diagnose CCSVI, since no validation of these criteria was performed by different and independent observers nor were they blindly compared with a validated gold-standard investigation. The European Society of Neurosonology and Cerebral Hemodynamics (ESNCH) has considerable concerns regarding the accuracy of the proposed criteria for CCSVI in MS. Therefore, any potentially harmful interventional treatment such as transluminal angioplasty and/or stenting should be strongly discouraged.

Original languageEnglish
Pages (from-to)2585-2589
Number of pages5
JournalJournal of Neurology
Volume259
Issue number12
DOIs
Publication statusPublished - Dec 2012
Externally publishedYes

Keywords

  • CCSVI
  • Multiple sclerosis
  • Ultrasound

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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