Our debut episode of WCBA gave a critical appraisal of the reaction - inside and outside the medical community - to the Zamboni procedure for patients with multiple sclerosis or MS. The treatment is also known as venous angioplasty to relieve chronic cerebro-spinal venous insufficiency (CCSVI). The issue is of paramount importance in this country, since Canada has one of the highest rates of MS in the world. The Zamboni procedure is not available here, so Canadians have been travelling to countries such as Mexico, Poland and Romania to have the procedure done there. Canadian doctors and the MS Society of Canada have urged patients to wait for more proof from clinical trials before having the procedure. Now, there are new concerns about the safety of the Zamboni procedure.
As reported on CBC News, some Canadians with MS who have received the Zamboni procedure have developed complications that may be due to the treatment. According to the CBC report, Gordon Layh of Bonnyville, Alberta, went to Poland to have the Zamboni procedure in June. Following the treatment, Layh told the CBC he was less fatigued and could speak better.
Nine weeks later, Layh said his condition began to deteriorate. According to the CBC, Layh's neurologist diagnosed two blood clots near a stent which was inserted into the vein that had been unblocked via the Zamboni procedure. Mr. Layh is receiving blood thinners to try and prevent the clots from getting bigger. There are concerns that the clots could extend into the brain.
The significance of this finding remains uncertain. A quick check of the US National Library of Medicine database turned up no references to blood clots that occur in veins treated with the Zamboni procedure. We don't know how often it occurs and how serious it is. We also don't know if Mr. Layh's condition has deteriorated because of or in spite of the clots.
And that is precisely the point. Months after many patients with MS had the Zamboni procedure, medical science still has not handed doctors defintive answers on the benefit and the risk of the procedure.
My opinion regarding the procedure hasn't changed. In the absence of proof, doctors shouldn't recommend the Zamboni procedure and the health care system shouldn't pay for it.
According to the CBC story, doctors are reluctant to treat complications from the Zamboni procedure unless there's an emergency.
Even Paolo Zamboni, the Italian doctor after whom the procedure is named, recently urged MS patients to wait for the results of more clinical trials before rushing abroad for treatment.
Given the latest developments, I agree.