CCSVI, or Chronic Cerebrospinal Venous Insufficiency, was coined in 2008 by Dr. Paolo Zamboni from the University of Ferrara, Italy. He identifies a technical diagnosis of CCSVI when two or more of five indicators are observed using duplex ultrasonography. These five indicators are what make up the Zamboni protocol for CCSVI testing. They are:
1. Reflux in the internal jugular veins, in the vertebral veins, or both, when the head is in any position. Measurements are to be taken when patient is breathing normally and not whilst coughing.
2. Reflux in the deep cerebral veins, and/or in other vein segments of the intracranial compartment.
3. High-resolution B-mode evidence of internal jugular vein stenosis (high-resolution Doppler ultrasound indicates stenosis in an internal jugular vein).

Doppler Sonography
4. No flow detected by Doppler in one or both the internal jugular veins or vertebral veins.
5. Reverted postural control of the main cerebral venous outflow pathways (meaning when a cross sectional area of the internal jugular vein is wider in a sitting position than in the supine posture, which indicates abnormal venous blood drainage in the sitting/upright position).
In the US doctors have not always used the Zamboni protocol for CCSVI testing. This is due to the fact that they are usually not trained in CCSVI diagnosis using the sophisticated duplex ultrasonography that Dr. Zamboni’s team uses. Confirmed blockages or malformations of all or some of the major veins draining the brain and spine are what physicians in the US tend to go on, and or by the presence of reflux.

Angeles Hospital in Tijuana, Mexico
Angeles hospital in Mexico is at the forefront of CCSVI testing and treatment. To discover more about our state of the art luxury facility in Tijuana and our high standards of patient care please contact us using the form to the right.
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