CCSVI Center | Multiple Sclerosis Treatment | Frankfurt
Welcome to CCSVI Center in Frankfurt, Germany
The CCSVI-Center Frankfurt/ Germany was founded by Prof. Stehling in 2010, motivated by Prof. Zamboni's work regarding the potential vascular origin of multiple sclerosis and the demand by MS-patients for treatment.
Because of the novelty of CCSVI, with few studies being available to assess long term outcomes, our primary goal at the CCSVI-Center Frankfurt is expressed by "primum nil nocere" - avoiding harm to patient as our primary objective.
To achieve this goal we have formed collaboration between experts in the field of diagnostic imaging and vascular intervention who each are linked into an international network of specialists. This guarantees the highest level of proficiency in the diagnosis and treatment of CCSVI, the avoidance of negative side effects and complications and the participation in the rapid exchange of expert knowledge.
The close spatial relationship between demyelization plaques and venous vessels on which CCSVI based, was postulated before 1980s as also the link between venous outflows disorders in the brain and the development back marks of MS.
Multiple sclerosis (MS) has been considered for many years to be an autoimmune disease, but recent research from Italy points out a possible new cause. According to the theory of Prof. Paolo Zamboni, a vascular surgeon from Ferrara, narrowings (stenoses) in jugular veins (neck) or the azygos veins returning the blood from the head to the heart, might be responsible for the development and the symptoms of MS (Multiple sclerosis).
The blood vessels constriction prevents blood flowing quickly enough (so-called reflux, where the blood vessels does not work properly and the blood flows into the brain again), with the consequence that iron is deposited in the brain (it could be seemed as white plaques visible on the MRI scan) causing autoimmune inflammation damaging the protective myelin nerve coating in the spinal cord and in the brain.
This condition has become known as "CCSVI”: chronic cerebro-spinal venous insufficiency.
Widening of the stenotic (narrowed) veins increases the blood flow through them, thus, relieving the back-pressure and eliminating the inflammation, which is causing the damage to the brain, the spinal cord and protective myelin.
CCSVI investigation and diagnosis at CCSVI-Center (Frankfurt/Germany):
MRV-Screening - CCSVI Diagnostics following a modified and advanced Haacke Protocol.
In order to diagnose the CCSVI, CCSVI-Center in Frankfurt uses non-invasive or mini-invasive CCSVI investigations methods. Our experience and our collaboration with the vendors of medical equipment and medical scientists around the world helped us to improve the CCSVI Diagnosis protocols, in order to provide reliable and safe diagnostic for our patients.
Identification of CCSVI according to Zamboni is based on three methods:
Ultrasound examination (only head and neck)
The limitation of ultrasound is that it cannot assess the intrathoracic and abdominal venous system.
But it provides real-time information about blood flow dynamics, which is necessary to assess reflux in the lower internal jugular vein segment, that is important for the blood flow from the brain to the heart.
MR-Venography (head, neck, thorax and abdomen - Haacke protocol)
MR venography showing with color coding demonstrating focal stenosis of the upper internal jugular veins (IJV).
Improved Haacke Protocol by CCSVI-Center in Frankfurt
We have implemented the following improvements for the Haacke protocol:
Combination of fast non breath-hold mr-venography (MRV) followed by slower breath-hold MRV for the lower neck and upper thoracic venous system
Flow-visualization along the internal jugular veins (IJV)
Flow visualization of the azygos vein-superior vena cava junction
Improved multi breath-hold single-volume equilibrium MRV of the thoracic and abdomino-pelvic venous system Examples of the respective improvements are show below.
The Haacke MR-protocol has been established as the standard for MR-venography and flow measurements in the work-up of CCSVI. It has, however, several drawbacks. Since MR-venography is carried out without breath holding and without cardiac gating, the azygos vein, that drains the blood from the spinal cord, cannot be depicted with sufficient accuracy on MRI
3.Catheter venography under fluoroscopy
Catheter venography or venogram, as a specialized form of angiography, is a medical imaging technique used to image the inside of blood vessels. This is traditionally done by injecting a contrast agent into the blood vessel and imaging with an X-Ray based technology such as fluoroscopy.
During catheter venography, a long, thin, flexible plastic tube (catheter) is inserted into the body, usually through a vein in the groin. The catheter is then threaded through the vascular system to the area requiring examination. A contrast dye is injected through the catheter and a rapid series of x-rays is taken, offering a detailed look at the specific blood vessels under the question.
Catheter Venography showing the mild midlevel stenosis
The costs for CCSVI investigations, including coordination, mediation and English language support depend on the art of the necessary investigation, additional packages and start from € 1050 to € 2500.
Safety of the Treatment
Over the past 18 months we have successfully treated well over 400 patients, without complications.
Results of CCSVI and Multiple Sclerosis liberation Treatment
Improvement oft the motoric system /
Treatment response in
More than 90 % of our patients have an improvement after the treatment.
Since January 2010, CCSVI –Center in Frankfurt (Germany) as one of the pioneer in this field has been diagnosing CCSVI in MS patients using the most advanced diagnostic methods and equipment, like as a high-speed CT scanner, doppler/ ultrasound and MRI scanner.
CCSVI –Center in Frankfurt not only uses the CCSVI protocols developed by Dr. Zamboni and Professor Haacke, but also makes an improvement on it. Besides the "Ballooning" or Angioplasty procedure, the so-called "liberation treatment or therapy", which can reverse the CCSVI, with normal balloons, we provide also the treatment with High-Pressure balloons, in order to minimize the risk of a so-called restenosis.
We use also the CCSVI Venous Stents for the treatment of the recurrent CCSVI or venous stenosis.
At present more than 400 Patients have safely and successfully undergone treatment via CCSVI – Center in Frankfurt!
Thanks to the high professionalism of our physicians and our experience in this field the
diagnostic and the treatment takes normally only 2 days.
Additional to CCSVI Liberation Angioplasty Treatment we offer also to our patients enhanced Treatment with bone marrow adult autologous Stem Cells and special Physiotherapy
CCSVI is an unproven theory and criticized by some Neurologist world-wide. “It is very dangerous and all placebo” some Neurologists say.
We and other Neurologists do not agree: As for safety, we have not seen any dangerous complications.
But: any kind of medical treatment will cause side effects to some extent, even pharmacotherapy of MS.
And for placebo: Well, we do not know for sure until the results from well designed randomized trials are available. But placebo effects usually do not occur in almost all treated patients. And they do not last for as long as a whole year.
In synopsis of the overall safety record of CCSVI treatment and experience of our patients, particularly in view of the impressive improvements treated patients have experienced, we consider it unethical to withhold this treatment from those patients who are aware of and willing to accept its experimental nature.
"Liberation Treatment" of CCSVI - Chronic Cerebro-Spinal Venous Insufficiency
Research from Italy indicates that stenoses (narrowings) of veins, vessels which drain the blood from the brain back to the heart, might be responsible for the development and symptoms of multiple sclerosis (MS). The disease has become known under the term "CCSVI - chronic cerebro-spinal venous insufficiency".
Dr. Paolo Zamboni, a vascular surgeon from Ferrara in Italy, has demonstrated this in a recently published scientific study on patients with multiple sclerosis. The treatment is easy: A simple widening of the narrowed veins a method which has become known under the term "liberation treatment".
In the group of the treated patients the percentage of active lesions in the brain and spine dropped from 50 % to 12 %. Compared to the relapse rate of 50 % within two years before the treatment, 73 % of the treated patients had no further relapses within two years after the treatment. The treated patients also had a significant improvement of their cognitive and motor function - as measured by test called MSFC scale - compared to untreated patients who showed no such improvements, 3D rendering of the venous system of the head and neck in an MS patient with narrowings (stenoses) [arrows] of the veins draining the brain.
For MS patients: CCSVI Screening- and Treatment Programme
In collaboration with Boston University School of Medicine we have developed a non-invasive screening programme for MS patients to reliably detect venous stenoses of the head, neck and chest. "Extended region MR-venography" affords a high-resolution, three-dimensional depiction of the vessels (veins) draining the head within 15 to 20 minutes without any radiation hazard.
If stenoses can be detected, quantitative flow measurements can be performed to provide information about the pressure inside the veins. Relevant stenoses can be treated minimally invasively by dilation with balloon-catheters and, if necessary, stents.
Treatments & Prices
CCSVI Treatment by reducing the increased venous pressure due to dilatation or stenting of the narrowed or blocked veins
According to Zamboni and earlier researchers, the inflammatory lesions and symptoms of multiple sclerosis (MS) can be caused by increased venous pressure in the brain´s and spine´s veins, the vessels which return the blood to the heart. The increased pressure results in deposition of the blood´s iron around the small veins in the brain, in turn inducing an inflammatory reaction. This is the process believed to be responsible for CCSVI.
Treatment according to this theory is based on relieving the increased venous pressure by opening up blocked or narrowed (stenosed) veins in the neck, chest and abdomen.
Outline of CCSVI Treatment – Second Day
After these so called stenoses have been identified by MR venography, ultrasound/ doppler and catheter venography, they can be treated by dilation, i.e. widening of the narrowed sections of critical veins. Critical here means that not all stenoses are believed to cause CCSVI: the main culprits seem to be located at the lower internal jugular veins (neck veins) and in the azygos vein (inside the chest).
The procedure takes between 1 - 2 hours and is generally pain free. Only during the balloon inflation a pressure can be felt by some patients at the site of the dilatation.
The Costs for CCSVI Treatment
The costs for CCSVI Treatment, including coordination, mediation and English language support depend on the art of the necessary investigation, additional packages, like High-Pressure Balloon Dilatation, and start from€ 3900 up to € 5000.
The CCSVI Liberation treatment or Angioplasty enhanced with adult autologous stem cells
Due to the latest scientific research in this area which describes long-term results of stem cell transplantation for MS Patients and experience of our patients we offer also the CCSVI Liberation treatment enhanced with adult autologous stem cells.
With this enhanced protocol, liberation angioplasty will be complemented with adult autologous stem cell therapy. After liberation angioplasty improves the blood flow through the stenotic (narrowed) veins, the introduction of adult autologous stem cells offers the potential to regenerate the damaged areas inside the brain and/or spinal cord and to decrease inflammation throughout the body.
The treatment is provided on homological basis personally by doctors after the examination in person.
The costs for CCSVI Treatment enhanced with adult autologous stem cells
The costs for CCSVI Treatment enhanced with adult autologous stem cells, including CCSVI Diagnostic, Angioplasty and Stem cells Treatment and also coordination, mediation and English language support depend on the art of the necessary investigation, additional packages and start from € 10950 up to € 15500.
Venous stents are now available for the treatment of (recurrent) venous stenoses.
The stents used at the CCSVI-Center in Frankfurt are wide enough for the large diameter of veins and ultra-flexible, a prerequisite for long-term patency in veins and may be used normally in the cases of so-called Restenosis (a condition where a previously treated vein segment becomes re-occluded).
Contrary to arteries, which have thick and rather rigid walls, veins have thin, very flexible walls, which allow the veins to change their shape and diameter according to blood volume and external pressure. Stiff arterial stents, which cannot change their shape together with the vein which accommodates them, might injure the thin wall of the veins, thus increasing the risk for thombosis.
Also, flexibility reduces the risk of dislodgement, by ensuring that the stent fits snugly into the vein. The stents are made from a space-age alloy, Nitinol, which can “remember” the shape in which they were manufactured. This makes the stents easy to deliver via catheter. The compatibility of Nitinol with magnetic resonance imaging allows MR-exams with stents in place to be carried out without risk for the patient.
The stents come in different sizes to suite the specific shapes and sizes of veins.
The stent is delivered via a balloon catheter. At the stenosis, the stent is expanded and pressed against the vessel wall by inflating the balloon. When the balloon is subsequently deflated, the stent stays in place and keeps the vessel open.
The costs for CCSVI Stent Implantation
The costs for CCSVI Stent Implantation, including coordination, mediation and English language support depend on the art of the necessary investigation, additional packages and start from € 4950 to € 6900.
Approach to physiotherapy treatment for MS patients
The human body can be trained – no matter what age and despite illness.
Before training can start, there has to be a thorough evaluation of the current physical condition.
Only then the ideal training pulses can be applied.
Extent and duration of improvement of MS-patients highly depends on the implementation of Physiotherapy. Since this is not guaranteed, neither everywhere nor regularly, the CCSVI-Center (Frankfurt/Germany) together with ambulant Physiotherapy Center has developed a medical physiotherapeutical program for MS-patients. This is a targeted therapy approach, which begins with an individual physiotherapeutical diagnosis and instruction and can also be done at home, due to an prescribed plan for training.
The extent of physical and therapeutical performance can be chosen individually by each patient. The base is Modul 1 (Basispackage) which can be extended at any time with other modules.
The costs for CCSVI Physiotherapy
The costs for CCSVI Physiotherapy, including coordination, mediation and English language support depend on the art of the additional packages and start from € 650.
Accommodation of the Patients and accompanying persons
Thanks professionalism and experience of our physicians the CCSVI Diagnostic and Treatment are non-invasive or mini-invasive and do not require the accommodation in the CCSVI-Center overnight.
The accommodation of the Patients and accompanying Persons can be booked at one of the following hotels thereabouts:
MARITIM Hotel Frankfurt
(two wheelchair rooms)
Room rates € 165,00 for a double room(breakfast not inkl.)
Qualifications, Accreditations & Certifications
To explore CCSVI scientifically and provide professional medical care the CCSVI-Center in Frankfurt has assembled a team of Neurologists, diagnostic and interventional Radiologists and Cardiologists for the diagnostic work-up and treatment of patients with CCSVI
We have also established international collaborations with research institutions also interested in CCSVI, most notably Prof. Zamboni himself and Profs. Kim and Kabutei from Boston University School of Medicine in the US and are in correspondence with other researchers such as Prof. Haacke.
A preliminary publication of our experience with CCSVI appeared at the RSNA (Radiological Society of North America) meeting in Chicago 2010. We are currently evaluating our data of more than 200 patients for publication.
We have established a network of collaboration partners who are actively pursuing CCSVI:
Ducksoo Kim, MD, Professor of Radiology, Boston University Medical Center, Boston USA
Dr. Salvatore J.A. Scalfani, MD, Professor of Radiology, SUNY Downstate Medical Center, New York, USA
David A. Koff, MD, Professor of Radiology, McMaster University, Hamilton, Ontario, Canada
Michael K. Stehling, MD, PhD
Director, Institut für Bildgebende Diagnostik (link zu IBD EN), Frankfurt, Germany
Lecturer, Ludwig-Maximilians University in Munich, Germany
Associate Professor of Radiology, Boston University, USA
Ducksoo Kim, MD
Head, Interventional Radiology
Boston University Medical Center, Boston
Professor of Radiology, Boston University, USA
Kirsten Holsteg, MD
Institut für Bildgebende Diagnostik (link zu IBD EN), Frankfurt, Germany
Stephan Zapf, MD
Institut für Bildgebende Diagnostik (link zu IBD EN), Frankfurt, Germany
“Already the next day I felt more strength, energy and walked more upright with a lighter step…” Peteriina Vainola-Grund
"Burning in the right side of the neck region disappeared the second day after treatment. Much positive here to make my life easier…" Vega Jorunn K.
"Able to climb stairs like a normal person, one leg after the other.
I am noticing little things daily but am happy with the outcome…" C.T., Canada
“As you saw the day after the intervention, Jacques was feeling much better. It's been almost 1 month since Jacques had the intervention. He has never felt better. He doesn't have any symptoms anymore. Everything is back to normal…” Lucie Godbout and Jacques Champagne, Canada
“Muscle pain is now gone I do not have muscle cramps or muscle stiffness any more I have a better flow of breathe I now have a better fine motor” Corrado Genta, Norway
Awards & Media Coverage
Parkinson’s disease and other degenerative diseases like ALS and Alzheimer linked to CCSVI?
Researchers focused on CCSVI now assume that there might be a links between Parkinson’s disease and CCSVI.
Iron deposits in the basal ganglia in Parkinson’s patients accumulate upstream from the venous drainage route. In some of these patients, venous stenoses, as described in CCSVI, have been identified. The similar iron deposition was found also in patients with Alzheimer’s (also known as Dementia) disease.
Also ALS (also Motor Neuron Disease (MND) or Lou Gehrig's disease) research shows that this disease is started by blood-spinal cord-barrier (BSCB) damage. Blood flow effects explain the blood-brain-barrier (BBB) damage in MS and may explain the BSCB damage in ALS. One of the hypotheses is that ALS is caused by constrictions in the vein draining the spinal cord and brain, which cause the venous reflux, which down-regulates tight junction proteins Occludin and ZO-1, which leads to breaks in the tight junctions between endothelial cells in the veins, which leads to leakage of toxic blood components into CNS tissue. If a venous constriction can be reached endovascularly it can be dilated, and such dilation may constitute cure of ALS.
To further explore these findings, the CCSVI-Center in Frankfurt, Germany, has begun to examine patients with other degenerative diseases like Parkinson, ALS and Alzheimer with a special Haacke MRI-protocol and duplex sonography to determine, whether the CCSVI criteria can be found in a higher percentage of cases than in the normal population.
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