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Evidence to Improve Care

Update on Multiple Sclerosis and Chronic Cerebrospinal Venous Insufficiency (CCSVI)


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee has undertaken a preliminary evidence review of the safety and effectiveness of endovascular treatments for the proposed condition known as chronic cerebrospinal venous insufficiency in patients with multiple sclerosis and is unable to make any recommendation at this time due to the paucity of available evidence. The committee regards this treatment as experimental at this time.

  • Evidence concerning the prevalence of chronic cerebrospinal venous insufficiency available up to July 2011 was reviewed by the Ontario Health Technology Advisory Committee, and no changes to the May 2010 recommendations were deemed necessary.

Read the full OHTAC Recommendation Report



Multiple sclerosis (MS) is a disease of the brain and spinal cord. The body’s immune system attacks the protective covering around the nerves that control movement and other body functions. This damage can result in slower or blocked communication between the brain and the rest of the body. People with MS may experience symptoms such as numbness, weakness, double vision or difficulty speaking. The disease tends to get worse over time and can lead to permanent disabilities.


Multiple Sclerosis and Chronic Cerebrospinal Venous Insufficiency

A recent theory proposed that an abnormality in the vein that drains blood from the brain and spinal cord may be associated with MS and that treating this problem might hold promise as a treatment for MS. The abnormality is known as chronic cerebrospinal venous insufficiency.


Update on Multiple Sclerosis and Chronic Cerebrospinal Venous Insufficiency: A Preliminary Evidence Review (PDF)
December 2011


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The Ministry of Health and Long-Term Care endorses this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with this recommendation.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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