Chronic cerebrospinal venous insufficiency controversy

Chronic cerebrospinal venous insufficiency, abbreviated CCSVI, is a term invented by the Italian researcher Paolo Zamboni in 2008 for compromised flow of blood in the veins draining the central nervous system. Zamboni hypothesized that it might play a role in the cause or development of multiple sclerosis, and he devised a surgical procedure, nicknamed the liberation procedure, that uses venoplasty or stenting of certain veins. His ideas are very controversial, with far more detractors than supporters, and treatments based on them are considered experimental. His first published research was neither blinded nor controlled and did not disclose his financial ties to the maker of the ultrasound used in diagnosis. The procedure has been criticised for serious complications and deaths, and the United States Food and Drug Administration said in 2012 that it is unclear whether CCSVI exists as a clinical entity. A 2013 study found CCSVI equally rare in people with and without multiple sclerosis, and a 2018 study in Neurology did not support venoplasty for improving symptoms or the disease course.