CCSVI procedure

Qualification for the treatment

Only patients with SM who have symptoms of cerebral and spinal cord outflow disorders, which is chronic cerebrospinal venous insufficiency – CCSVI, are qualified for the treatment. That is why examinations checking the patency of jugular and vertebral veins as well as azygos vein are carried out. If the stenosis or lesion of the above mentioned vessels is found the treatment procedure can be commenced.

Qualification for the treatment can be made after the consultation of vascular surgery or angiology consultant doctor and Doppler ultrasound results.

Our package includes the following positions:

Vascular surgeon/angiologist consultation.
Neurologist consultation – before and after the procedure.
Magnetic resonance examination of jugular and mediastinal veins (MRI).
Doppler examination of internal jugular veins before and after the procedure.
Eye examination (OCT).
Venography, which is a contrast Roentgen examination of jugular and mediastinal veins.
Endovascular procedure (angioplasty or stenting).
A set of basic post-procedure medications for a week.
5- night stay in a 4-star hotel (breakfast included) – double room.
Transport to the examination and procedure facilities.
Transport from/to Pyrzowice (Katowice) or Balice (Kraków) Airport.
EuroMedic personnel assist during your stay.
Telephone hot-line assistance.
Massage therapy and rehabilitation consultation.
45 minutes massage session for the accompanying person.
Dentist visit voucher – free dental check-up.
ECG test.

IMPORTANT!

Venography is the most precise examination and its result determines finally whether the patient can be qualified for the treatment. The contrast is applied through a catheter directly to the examined vessel. Patients who are allergic to contrast should inform the doctor about it.

Other examinations and consultations before the treatment

Before the treatment patients are asked to fill in EDSS (Extended Disability Status Scale) and MSIS-29 (Multiple Sclerosis Impact Scale-29) questionnaires assessing the degree of their disability. On the day of admission to hospital ward the basic blood tests are carried out (morphology, electrolytes, blood type, coagulation and bleeding time) necessary for the safe performance of the operation. Women take a pregnancy test.
Neurological consultation is carried out at the hotel (for patients accommodated in the hotel) as well as in the hospital before and after the treatment.

Hospital treatment

Patients are admitted to the ward on the day of their treatment in the morning. The procedures are usually carried out from 10am till the afternoon. Patients awaiting the treatment should come with an empty stomach. During their stay in patients’ room they have fluids infused into a vein, they are also given painkillers and sedatives.

The treatment, which usually takes no longer than 1h, is performed in local anaesthesia. After the procedure, a pressure dressing is applied for about 5 hours in order to prevent bleeding from the punctured vein. In case of prolonged bleeding the dressing is kept for a longer period of time. About 3 hours after the treatment the patient can drink and eat.

The patient stays at the ward until the morning the following day. During the discharge from the hospital patients receive an information card including a description of the performed treatment and indications concerning further treatment, patients will also receive a set of basic post-procedure medications for a week.

IMPORTANT!

In case of alarming symptoms or complaints you should contact the office staff or the hospital ward where there is always a doctor on duty.

Pre-operative indications

Before arriving at the hospital groin areas should be shaved.
Before the treatment the patient is obliged to wear hospital clothes received in the Clinic.
If the patient uses a wheelchair s/he should bring it with her/hi.
If the patient follows a special diet s/he should inform the coordination office about it.
The patient should bring with her/him toiletries, pyjamas (track suit), footwear to the hospital.
In the form the patient should inform the doctor about taken medicin.
On the day of admission the patient should come with an empty stomac.
The patient should bring all required documents.
6 hours before the treatment the patient should not eat.
3 hours before the treatment the patient should not drink any fluid.
Before the treatment all metal elements (jewellery) should be removed.

Treatment description

During the procedure, instruments are put via femoral vein which enables lumen widening of the vessel stenosis. Widening of the vessel enables the outflow of venous blood from the central nervous system which can alleviate the diagnosed symptoms.

By a vein puncture, usually femoral vein puncture, a catheter is put to the ostium of the vessel stenosis. Via catheter canal a wire is put whose position can be controlled on the monitor using Roentgen rays.

In the place of stenosis a catheter with a balloon is put, where the size of the balloon is chosen in accordance with the vessel diameter. Having carefully placed the balloon, it is filled with liquid (a mixture of contrast medium and 0.9 % NaCl solution) for a few minutes, under the pressure of a few to a dozen or so atmospheres. After widening of the stenosis the liquid is removed from the balloon and then the balloon itself is removed, too. Widening effect is controlled immediately after balloon removal.

If the widening is successful and we find improvement of blood outflow from the vessel, then at this stage the patency procedure is finished.

If despite the widening, there is still vessel stenosis and blood outflow is blocked, a stent implantation is done in the place of the stenosis. Stent is a kind of catheter built from a thin mesh implanted into the vessel lumen in order to increase and keep its patency. It prevents restenosis of the widened vessel.

The stent is not removed from the vessel, it stays in the body for a lifetime. It does not limit everyday activity in any way but it obliges the patient to regular taking of medicines decreasing blood coagulation such as Aspirin or Cropidogel.

During the treatment so called Cutting Balloon is also used. A cutting balloon is an angioplasty device used in percutaneous coronary interventions. It has a special balloon tip with small blades, that are activated when the balloon is inflated it allows the vessel diameter to be widen.

IMPORTANT!

When the Patient does not agree to stent implantation, the stent is not implanted. However in that case the procedure may not have the desired effect.
Implanted stents are not a contraindication against further magnetic resonance tests of the central nervous system.

Post-operative indications:

Take care of the incision in place of puncture, it should not be touched or wet.
After the procedure stay in bed for at least 5 hours.
After the treatment it is forbidden to take narcotic substances (including marijuana) and alcohol.
It is recommended to avoid effort for 14 days after the treatment (lifting heavy things, physical effort)
To obtain doctor’s sick leave, please inform a doctor about it.

Check-ups

In order to optimize safety of the performed treatments and to learn about their healing effect we have prepared check-ups schedule.

Check – up visits after the angioplasty and angioplasty with cutting balloon:

I check-up - 6 months after the performed procedure.

Consultation of vascular surgery or angiology consultant doctor.
Neurological consultation.
USG Doppler examination of jugular venous vessels.
Possible venograph.
Ophthalmologist consultation.

II check-up – 12 months after the performed procedure.

Consultation of vascular surgery or angiology consultant doctor.
Neurological consultation.
USG Doppler examination of jugular venous vessels.
Possible venography.
Ophthalmologist consultation.
Magnetic resonance examination of jugular and mediastinal veins (MRI).

Check – up visits after the stent implantation:

I check-up - 3 months after the performed procedure.

USG Doppler examination of jugular venous vessels.

II check-up – 6 months after the performed procedure.

USG Doppler examination of jugular venous vessels
Neurological consultation
Ophthalmologist consultation

III check-up – 12 months after the performed procedure.

USG Doppler examination of jugular venous vessels
Neurological consultation