737:(CIHR), the federal agency responsible for funding health research, recommended in 2010 against funding a pan-Canadian trial of liberation therapy because there was a lack of evidence on the safety or efficacy of the procedure. It suggested a scientific expert working group made up of the principal investigators for the seven MS Society-sponsored studies. The health minister accepted the CIHR recommendation and said that Canada was not going to fund clinical trials. The expert panel was created by the end of 2010 together between the CIHR and the MS Society of Canada. It has been proposed that the creation of this expert panel was partly directed to cope with the high levels of social pressure the CCSVI theory had raised and at the same time try to maintain a scientific perspective in the funding and investigation of CCSVI. The main task of the panel was to monitor the results of the ongoing studies in the relationship between CCSVI and MS and recommend the funding of a clinical trial in case that there was evidence of a true relationship between the two. In 2011, the Canadian federal government announced that they would fund clinical trials of the procedure to widen the veins since CIHR considered that evidence of venous abnormalities in MS was enough for small treatment trials. It has been proposed that the recommendation to fund phase I and II trials instead of a big study was a compromise between the high levels of social and political pressure and the low level of evidence on the theory.
745:
access to CCSVI treatment in Canada, hope in the new treatment as a solution for their worsening health, and trust in the MS community and the organizations, clinics and doctors facilitating or providing the desired operation. Conversely, the other study concluded that sense of community and cooperation (from family, MS groups and the general population) was a key motivating factor. Other motivating factors included media reports, perception of approval from their health providers, the apparent low risk of the operation, or accessibility of the hospital that offered the procedure directly or through a medical tourism company. On the other hand, hesitating factors included the cost and effort required for the operation, the mistrust of foreign health systems, the underlying rationale for the operation, or advice against the procedure from trusted health providers.
668:
million hits. The
Internet has also been used to advertise places where stenting for CCSVI is performed, and to more generally disseminate all the information on CCSVI. Social media have served patient groups in their attempt to pressure official bodies to make decisions favoring funding of clinical trials, or the public coverage of stenting and venoplasty as treatments of MS. Likewise, social media have been accused of creating a division between CCSVI supporters and those who say it does not work. Indeed, they have been repeatedly used by advocates of the CCSVI theory to attack those who were more critical or cautious, most commonly with accusations of being tainted due to commercial relationships with
404:
484:
66:
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effort to find a cure for his wife, along with the improvement of some patients after its alleged treatment. Initial difficulty reproducing results connecting MS and CCSVI, combined with reports of secondary effects of the surgical procedure, led to a more cautious discourse proposing that more investigation in the relationship between CCSVI and MS was needed. The first fatality related to CCSVI treatment was a pivotal development in this trend towards a less optimistic media view of the theory.
38:
225:. While the initial article on CCSVI claimed that abnormal venous function parameters were not seen in healthy people, others have noted that this is not the case. In the report by Zamboni none of the healthy participants met criteria for a diagnosis of CCSVI while all patients did. Such outstanding results have raised suspicions of a possible
702:
public petition to the country health authorities in support of the "liberation treatment" had received over 17,000 signatures. The debate regarding funding in Canada has been considered to be specially informative as an example of extreme involvement of politics, due to public pressure, in decisions usually governed by scientific evidence.
592:
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healthy controls whereas the criterion of absence of flow and the criterion regarding stenosis are considered not valid since they are related to normal physiological processes and not pathology. These problems in the criteria have led some researchers to consider the criteria inadequate and more generally the concept of CCSVI flawed.
137:. Zamboni also did not disclose his financial ties to Esaote, the manufacturer of the ultrasound specifically used in CCSVI diagnosis. The "liberation procedure" has been criticized for possibly resulting in serious complications and deaths, while its purported benefits have not been proven. In 2012, the
679:
of efficacy, and do not constitute a scientific proof of the efficacy of the treatment since, for example, those who have had a positive result are more prone to post their cases than those who had little or no improvement, and the reported improvements in patients' condition can be attributed to the
578:
XI and XII. One death case appeared in the scientific literature, while 3 other deaths have been related to CCSVI treatment in the media. Some United States hospitals have banned the surgical procedure outside clinical trials due to safety concerns until more evidence to support its use is available.
523:
Kuwait became the first country in the world where treatment of CCSVI, as of 2010, was explicitly allowed by the medical authorities and paid by the state health system. As of 2010, the procedure was performed privately in 40 countries, and, despite existing recommendations, as of 2013 it is believed
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Diagnostic criteria have been criticized. Both the number of criteria and the need of being positive for two of them as enough for diagnosis are arbitrary ideas. Moreover, experienced groups in the use of ultrasound have not been able to show intracranial or extracranial reflux in MS patients or even
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There were further studies aimed at clarifying if there is a relationship between MS and CCSVI. In particular, the US and
Canadian MS societies launched seven such studies. Recent reviewers have shown "no significant difference in prevalence of CCSVI in people with MS compared to people without MS".
709:
committed to funding research on the connection between CCSVI and MS, although later in 2010 it came under criticism for opposing clinical trials of CCSVI therapy. The MS Society of Canada in
September 2010 reserved one million dollars toward CCSVI research "when a therapeutic trial is warranted and
659:
CCSVI has received a great deal of attention in all media, the scientific literature and on the
Internet. Moreover, the CCSVI case has been considered a good example of how new communication technologies and social media are modifying the traditional relationship between science, politics, medicine,
663:
Media coverage has been perceived by some as "hype", with exaggerated claims that have led to excessive expectations. This has been partially attributed to some of the investigators of the theory. Mainstream media initial approximations to
Zamboni's theory were enthusiastic and emphasized Zamboni's
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In May 2012 the U.S. Food and Drug
Administration issued a safety communication on CCSVI, stating that MS patients undergoing angioplasty and/or stenting to treat CCSVI risk serious injuries or death. Furthermore, it also noted that the benefits of these experimental procedures have not been proven
514:
in the US and Canada, which considered research on the effectiveness of CCSVI intervention to be inconclusive as of 2010. In March 2013 a press release indicated that the first prospective, placebo-controlled study of balloon angioplasty for MS had not shown any benefit of the therapy. The study, a
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should be considered the gold standard for the diagnosis of CCSVI. Use of magnetic resonance venography for the diagnosis of CCSVI in MS patients has been proposed by some to have limited value, and should be used only in combination with other techniques. Others have stated that magnetic resonance
2676:
Vedantham S, Benenati JF, Kundu S, Black CM, Murphy KJ, Cardella JF (September 2010). "Interventional endovascular management of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis: a position statement by the
Society of Interventional Radiology, endorsed by the Canadian
232:
Further studies of the relationship between CCSVI and MS have had variable results, with many failing to reproduce the association between MS and CCSVI. Moreover, the greatest predictor of positive results is researchers' involvement in the administration of the "liberation procedure". This effect
2505:
Hojnacki D, Zamboni P, Lopez-Soriano A, Galleotti R, Menegatti E, Weinstock-Guttman B, et al. (April 2010). "Use of neck magnetic resonance venography, Doppler sonography and selective venography for diagnosis of chronic cerebrospinal venous insufficiency: a pilot study in multiple sclerosis
744:
studies have investigated the motives and experiences of
Canadian patients traveling abroad to get the "liberation procedure". One of the studies identified three factors contributing to patients going abroad seeking treatment: a loss of faith in the Canadian health system when it did not provide
701:
While reasons are not completely clear, the CCSVI theory was received differently in Canada than other places. The public interest and number of media appearances were much greater than elsewhere, including Italy, and debate has been heated regarding funding. As an example, by the end of 2009, a
688:
Scientists and physicians transmitted their arguments regarding CCSVI inadequately, especially after the initial rising of the hypothesis. Their communication was characterized by an excessive hesitation and a lack of clear statements, as opposed to CCSVI proponents, who "won the communication
667:
The
Internet has been extensively used by patient groups to obtain and disseminate information on CCSVI. People with MS often read extensively about the CCSVI theory and its development on Internet sites, and a search for "liberation procedure" in Google as of August 2010 yielded more than 2.5
233:
goes to the extent that, when only fully independent studies are considered, no association at all is found. The poor reproducibility across studies and diagnostic modalities has led some authors to conclude that CCVSI might be nothing more than a clinically irrelevant sonographic construct.
391:. A study in 268 MS patients and 155 controls reported more a frequency of CCSVI in the MS group that was more than twice as high as in the controls group and was also higher in the progressive MS group than in the non-progressive MS group. This study found no relationship between CCSVI and
684:
effect. Patients' reasons for not publishing negative results may include embarrassment about the money spent in the procedure without effect and the negative reaction they expect from other people with MS. Caution has been recommended regarding patients' self-reports found on the web.
1526:
Traboulsee AL, Knox KB, Machan L, Zhao Y, Yee I, Rauscher A, et al. (January 2014). "Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their siblings, and unrelated healthy controls: a blinded, case-control study".
542:
Balloon angioplasty in a preliminary, uncontrolled, unblinded study by
Zamboni improved symptoms in MS in a minority of treated people. Although the procedure pushes the vein open temporarily, the effect does not persist, supporters advise against using stents.
3853:"Recommendations for multimodal noninvasive and invasive screening for detection of extracranial venous abnormalities indicative of chronic cerebrospinal venous insufficiency: a position statement of the International Society for Neurovascular Disease"
157:
of CCSVI originating multiple sclerosis. Additional research investigating the CCSVI hypothesis is underway. A 2013 study found that CCSVI is equally rare in people with and without MS, while narrowing of the cervical veins is equally common.
519:
clinical trial designed to evaluate safety and efficacy of endovascular treatment, enrolled initially 10 patients that received the treatment and 20 more afterwards that were either allocated to receive angioplasty or a placebo intervention.
3962:
748:
In 2013, a case-control study found evidence against the involvement of chronic cerebrospinal venous abnormalities in MS. Later in 2013 a study found that vein narrowing appears to be present equally in those with and without MS on
315:, and occurs more often with age, however these conditions are hardly ever seen in MS and the disease seldom appears after age 50. Finally, an organ-specific immune response is not seen in any other kind of venous disease.
965:
A chronic state of impaired venous drainage from the central nervous system, termed chronic cerebrospinal venous insufficiency (CCSVI), is claimed to be a pathologic phenomenon exclusively seen in multiple sclerosis
499:(CIRSE), recommend not using the proposed treatment outside clinical trials until its effectiveness is confirmed by controlled studies. Moreover, the CIRSE has stated that treatment research should begin by a small,
3801:
Lee BB, Bergan J, Gloviczki P, Laredo J, Loose DA, Mattassi R, et al. (December 2009). "Diagnosis and treatment of venous malformations. Consensus document of the International Union of Phlebology (IUP)-2009".
621:. Zamboni's results were criticized because his study was not blinded and his results needed to be verified by further studies. Zamboni had become interested in CCSVI in 1999 when his wife was diagnosed with MS.
149:
concluded "Our data do not support the continued use of venoplasty of extracranial jugular and/or azygous venous narrowing to improve patient-reported outcomes, chronic MS symptoms, or the disease course of MS."
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which, he proposes, should be used to diagnose CCSVI. Moreover, Zamboni's research center has also received support in the form of equipment and technical assistance from this manufacturer. These are potential
2256:
Worthington V, Killestein J, Eikelenboom MJ, Teunissen CE, Barkhof F, Polman CH, et al. (November 2010). "Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency".
781:(Union internationale de phlébologie-UIP- in French, its original working language) of which Zamboni is a member. The UIP for example proposed that developmental abnormalities were the primary cause of CCSVI.
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At a political level there have been contradictory positions, with some provinces funding trials, others stating that since therapy is unproven they should wait, and others urging for a pan-Canadian trial.
2847:
496:
3467:""I knew what was going to happen if I did nothing and so I was going to do something": faith, hope, and trust in the decisions of Canadians with multiple sclerosis to seek unproven interventions abroad"
996:
A similar condition involving the head and neck venous system may cause chronic cerebro-spinal venous insufficiency (CCSVI) and may be involved in the development or exacerbation of multiple sclerosis.
2478:
Simka M, Kostecki J, Zaniewski M, Majewski E, Hartel M (April 2010). "Extracranial Doppler sonographic criteria of chronic cerebrospinal venous insufficiency in the patients with multiple sclerosis".
978:
Lee AB, Laredo J, Neville R (April 2010). "Embryological background of truncular venous malformation in the extracranial venous pathways as the cause of chronic cerebro spinal venous insufficiency".
1765:
Diaconu, Claudiu I.; Conway, Devon; Fox, Robert J.; Rae-Grant, Alexander (5 February 2012). "Chronic Cerebrospinal Venous Insufficiency as a Cause of Multiple Sclerosis: Controversy and Reality".
299:
infection, parental ancestry, date of birth and geographic location. MS is also more common in women, while venous diseases are more common in men. Venous pathology is commonly associated with
3277:
2877:
Ludyga T, Kazibudzki M, Simka M, Hartel M, Swierad M, Piegza J, et al. (December 2010). "Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe?".
539:
have been proposed as treatment options for CCSVI in MS. The proposed treatment has been termed "liberation therapy" though the name has been criticized for suggesting unrealistic results.
613:
The term "chronic cerebrospinal venous insufficiency" was coined in 2008 by Paolo Zamboni, who described it in patients with multiple sclerosis. According to Zamboni, CCSVI had a high
1234:"Safety Alerts for Human Medical Products — Balloon angioplasty devices to treat autonomic dysfunction: FDA Safety Communication — FDA concern over experimental procedures"
3635:"Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their siblings, and unrelated healthy controls: a blinded, case-control study"
129:
There is no scientific evidence that CCSVI is related to MS, and there is no good evidence that the surgery helps MS patients. Zamboni's first published research was neither
122:
of certain veins. Zamboni's ideas about CCSVI are very controversial, with significantly more detractors than supporters, and any treatments based on his ideas are considered
145:
is not an approved use. In a 2017 study Zamboni et al. stated "Venous PTA cannot be recommended for patients with relapsing-remitting multiple sclerosis." In 2018 a study in
726:
funded observational studies in which patients who had already received the treatment were included. Over 2 million dollars were allocated to these studies. The province of
675:
Many patients who have had the surgical procedure report their improvements on social media websites such as structured patient databases and YouTube. Such stories are only
491:
Further trials are required to determine if the benefits, if any, of the procedure outweigh its risks. Most experts, and medical and patients organizations, including the
558:
While the procedure has been reported to be generally safe for MS patients, severe complications related to the angioplasty and stenting that have been reported include
2368:"Custom CGH array profiling of copy number variations (CNVs) on chromosome 6p21.32 (HLA locus) in patients with venous malformations associated with multiple sclerosis"
3229:
2775:
217:(abnormally narrowed) in around 90% of cases. Zamboni theorized that malformed blood vessels cause increased deposition of iron in the brain, which in turn triggers
921:
Khan O, Filippi M, Freedman MS, Barkhof F, Dore-Duffy P, Lassmann H, et al. (March 2010). "Chronic cerebrospinal venous insufficiency and multiple sclerosis".
4016:
2921:
2069:"Embryological background of truncular venous malformation in the extracranial venous pathways as the cause of chronic cerebro spinal venous insufficiency"
3829:
2855:
153:
Research on CCSVI was fast-tracked, but researchers have been unable to find a connection between CCSVI and MS. This has raised serious objections to the
4589:
3722:
141:
states that it is not clear if CCSVI exists as a clinical entity and that these treatments may cause more harm. In 2017 they emphasized that this use of
138:
3679:
3170:
511:
3287:
3251:
2116:
Simka M (May 2009). "Blood brain barrier compromise with endothelial inflammation may lead to autoimmune loss of myelin during multiple sclerosis".
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criteria of venous drainage have been proposed to be characteristic of the syndrome, although two are considered sufficient for diagnosis of CCSVI:
2718:
323:
Iron deposition as a cause of MS received support when a relationship between venous pressure and iron depositions in MS patients was found in a
487:
Balloon dilatation of stenosed jugular vein in a MS patient. Stenosis prevents the balloon from inflating (in the middle) while pressure is low.
3392:
734:
3137:
2294:
Haacke EM, Garbern J, Miao Y, Habib C, Liu M (April 2010). "Iron stores and cerebral veins in MS studied by susceptibility weighted imaging".
769:
Several national and international organizations have been created to further the research and dissemination of the CCSVI theory, such as the
693:
to be self-critical and give appropriate responses to the questions that globalization of the theory raises, especially among people with MS.
4361:
3929:
1479:"Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency (CCSVI) in people with multiple sclerosis"
1080:
804:
547:
2629:"Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency"
4366:
3779:
706:
1233:
492:
2068:
3525:"Navigating the "liberation procedure": a qualitative study of motivating and hesitating factors among people with multiple sclerosis"
1824:
770:
2418:
Weinstock-Guttman B, Zivadinov R, Cutter G, Tamaño-Blanco M, Marr K, Badgett D, et al. (February 2011). Kleinschnitz C (ed.).
252:
studies to define the possible relationship between CCSVI and MS, although existing data did not support CCSVI as the cause of MS.
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3696:
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van Rensburg SJ, van Toorn R (November 2010). "The controversy of CCSVI and iron in multiple sclerosis: is ferritin the key?".
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venography is a valid measure which has advantages over Doppler including the fact that results are more operator-independent.
891:
Al-Omari MH, Rousan LA (April 2010). "Internal jugular vein morphology and hemodynamics in patients with multiple sclerosis".
4467:
3683:
758:
451:
3576:"Evidence against the involvement of chronic cerebrospinal venous abnormalities in multiple sclerosis. A case-control study"
1369:
Ghezzi A, Comi G, Federico A (February 2011). "Chronic cerebro-spinal venous insufficiency (CCSVI) and multiple sclerosis".
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battle, at least in the early rounds." A positive effect of the important media coverage may be that it forces the world of
2783:
483:
4279:
2210:
Handel AE, Lincoln MR, Ramagopalan SV (August 2010). "Chronic cerebrospinal venous insufficiency and multiple sclerosis".
1994:"Chronic cerebrospinal venous insufficiency and multiple sclerosis: a comprehensive meta-analysis of case-control studies"
1891:""Liberation treatment" for chronic cerebrospinal venous insufficiency in multiple sclerosis: the truth will set you free"
4504:
2420:"Chronic cerebrospinal vascular insufficiency is not associated with HLA DRB1*1501 status in multiple sclerosis patients"
1435:"Chronic cerebrospinal venous insufficiency and the doubtful promise of an endovascular treatment for multiple sclerosis"
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1211:
799:
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4599:
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3744:
1940:"Is there any relation between chronic cerebrospinal venous insufficiency and multiple sclerosis? - a critical review"
614:
516:
507:
403:
3723:"What's the Latest on CCSVI and MS? Discover New Research at the National CCSVI Society's Major Canadian CCSVI Forum"
3388:
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that are not associated with CCSVI. Evidence linking CCSVI and iron deposition is lacking, and dysregulation of iron
3437:
3418:
4790:
4700:
4351:
4326:
4143:
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4002:
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Tsivgoulis G, Faissner S, Voumvourakis K, Katsanos AH, Triantafyllou N, Grigoriadis N, et al. (January 2015).
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was more aggressive and provided 2.2 million dollars for some of its residents to be included in a clinical trial.
571:
4725:
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1992:
Tsivgoulis G, Sergentanis TN, Chan A, Voumvourakis K, Triantafyllou N, Psaltopoulou T, et al. (March 2014).
1072:
757:. The results of the study were described as a "death knell" for Zamboni's theory. Another study released by the
723:
4477:
4472:
4710:
4523:
4296:
4274:
3977:
3837:
3730:
1571:
1207:"FDA Safety Communication: Chronic Cerebrospinal Venous Insufficiency Treatment in Multiple Sclerosis Patients"
669:
603:
504:
500:
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diseases make it difficult to include MS in this group. In its current form, CCSVI cannot explain some of the
3178:
2749:
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774:
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182:
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4715:
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4025:
2125:
1836:
1718:"The big idea: iron-dependent inflammation in venous disease and proposed parallels in multiple sclerosis"
930:
340:
336:
95:
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Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Gianesini S, Bartolomei I, et al. (December 2009).
1260:"Efficacy and Safety of Extracranial Vein Angioplasty in Multiple Sclerosis: A Randomized Clinical Trial"
754:
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2807:"A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency"
477:
356:
210:
186:
123:
17:
3204:"Information Sheet on Multiple Sclerosis (MS) and "Chronic Cerebrospinal Venous Insufficiency" (CCSVI)"
2726:
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and the general public. In this sense they have played a key role in effectively promoting the theory.
790:
In 2014 imaging criteria for venous abnormalities were published to help with research on this topic.
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noted in 1863 that the inflammation-associated lesions were distributed around veins. Later, in 1935,
4656:
4651:
4455:
4247:
3587:
2431:
1309:"Safety and efficacy of venoplasty in MS: A randomized, double-blind, sham-controlled phase II trial"
741:
644:
416:
408:
2130:
1841:
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Zamboni P, Tesio L, Galimberti S, Massacesi L, Salvi F, D'Alessandro R, et al. (January 2018).
935:
65:
4732:
4499:
1433:
Dorne H, Zaidat OO, Fiorella D, Hirsch J, Prestigiacomo C, Albuquerque F, Tarr RW (December 2010).
809:
332:
142:
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Zivadinov R, Bastianello S, Dake MD, Ferral H, Haacke EM, Haskal ZJ, et al. (November 2014).
3574:
Rodger IW, Dilar D, Dwyer J, Bienenstock J, Coret A, Coret-Simon J, et al. (14 August 2013).
842:
Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Tacconi G, Dall'Ara S, et al. (April 2009).
4646:
4556:
4138:
3662:
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2235:
2163:"Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis"
1862:
1717:
1654:
1599:
1552:
1394:
1307:
Traboulsee AL, Machan L, Girard JM, Raymond J, Vosoughi R, Hardy BW, et al. (October 2018).
1184:
1128:
1044:
956:
676:
618:
455:
277:
194:
134:
103:
1870:
229:, which originates on a diagnostic test not being used under clinically significant conditions.
2548:
Valdueza JM, Doepp F, Schreiber SJ, van Oosten BW, Schmierer K, Paul F, Wattjes MP (May 2013).
1823:
Khan O, Filippi M, Freedman MS, Barkhof F, Dore-Duffy P, Lassmann H, et al. (March 2010).
335:
of MS patients. Additionally iron deposition occurs in different neurological diseases such as
4437:
4386:
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3925:
3884:
3811:
3654:
3615:
3556:
3498:
3107:
2978:
2894:
2828:
2694:
2658:
2599:"Endovascular Treatment of Cerebrospinal Venous Insufficiency Safe, May Provide Benefit in MS"
2579:
2515:
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1969:
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1019:
Qiu J (May 2010). "Venous abnormalities and multiple sclerosis: another breakthrough claim?".
987:
948:
900:
873:
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A small genetic study looked at fifteen MS patients who also had CCSVI. It found 234 specific
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54:
3017:
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2013:
2005:
1959:
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1902:
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1774:
1737:
1729:
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1629:
Franceschi C (April 2009). "The unsolved puzzle of multiple sclerosis and venous function".
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venous malformations, including azygous stenosis, defective jugular valves and jugular vein
130:
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Ferlini A, Bovolenta M, Neri M, Gualandi F, Balboni A, Yuryev A, et al. (April 2010).
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trial which should be monitored by an independent organization. An exception has been the
273:
265:
249:
3633:
Traboulsee AL, Knox KB, Machan L, Zhao Y, Yee I, Rauscher A, et al. (January 2014).
2806:
3591:
2435:
2161:
Marrie RA, Rudick R, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T (March 2010).
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that he has never disclosed when publishing scientific articles, which would be against
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Putnam T (1935). "Encephalitis and sclerotic plaques produced by venular obstruction".
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2018:
1993:
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1503:
1478:
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1308:
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1259:
868:
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190:
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Definitive imaging study finds no link between venous narrowing and multiple sclerosis
3650:
3523:
Ploughman M, Harris C, Hogan SH, Murray C, Murdoch M, Austin MW, Stefanelli M (2014).
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3922:
CCSVI as the Cause of Multiple Sclerosis: The Science Behind the Controversial Theory
2352:
1603:
1572:"Chronic cerebrospinal venous insufficiency in multiple sclerosis: the final curtain"
1188:
1048:
595:
575:
443:
absence of flow in the internal jugular or vertebral veins on Doppler ultrasound, and
226:
87:
3666:
2906:
2286:
2239:
1866:
1658:
1556:
1398:
1132:
960:
440:
high-resolution B-mode ultrasound evidence of stenosis of the internal jugular vein,
4692:
4604:
4419:
4109:
4052:
3994:
3282:
2990:
1494:
727:
648:
607:
376:
324:
300:
296:
292:
218:
167:
99:
1103:"Experimental multiple sclerosis vascular shunting procedure halted at Stanford".
602:
Venous pathology has been associated with MS for more than a century. Pathologist
3982:
3600:
2444:
2336:
2270:
2178:
1324:
1275:
4757:
4153:
3697:"'Scientific quackery': UBC study says it's debunked controversial MS procedure"
844:"Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis"
532:
206:
3869:
3852:
3310:"MS Society sets aside $ 1M in case CCSVI patient trial developed and approved"
2690:
2139:
1733:
550:(PTA) has proven to be safe but due to its ineffectiveness is not recommended.
4673:
4663:
4624:
4568:
4561:
4391:
3971:
2890:
2823:
2644:
1778:
1382:
750:
638:
related to the highly sensitive ultrasound diagnostic systems manufactured by
567:
563:
423:
419:
387:
was suggestive of having an implication for angiogenesis as it interacts with
344:
178:
154:
115:
59:
3483:
3076:"Media, politics and science policy: MS and evidence from the CCSVI Trenches"
2598:
2045:
2009:
1786:
1642:
1451:
1434:
859:
205:
Zamboni and colleagues claimed that in MS patients diagnosed with CCSVI, the
4427:
4168:
4104:
4060:
4043:
4038:
2384:
174:
106:(MS). Zamboni also devised a surgical procedure which the media nicknamed a
3888:
3815:
3748:
3658:
3619:
3560:
3502:
3396:
3111:
3092:
2982:
2898:
2832:
2698:
2662:
2583:
2550:"What went wrong? The flawed concept of cerebrospinal venous insufficiency"
2519:
2491:
2463:
2403:
2344:
2307:
2278:
2231:
2196:
2147:
2087:
2027:
1973:
1924:
1858:
1751:
1702:
1693:
1676:
1650:
1595:
1548:
1512:
1460:
1390:
1342:
1293:
1180:
1124:
1040:
991:
952:
904:
877:
591:
3309:
2565:
4641:
4243:
4180:
4114:
4065:
3879:
3700:
3314:
777:. They are working together with already existing organizations like the
761:
in 2017 was described as a "definitive debunking" of liberation therapy.
583:
and that studies exploring a link between MS and CCSVI are inconclusive.
392:
384:
347:
in MS is more complex than simply iron accumulation in the brain tissue.
328:
312:
281:
269:
214:
119:
3954:
1955:
37:
3541:
3465:
Snyder J, Adams K, Crooks VA, Whitehurst D, Vallee J (September 2014).
1677:"Anomalous venous blood flow and iron deposition in multiple sclerosis"
719:
681:
446:
reverted postural control of the main cerebral venous outflow pathways.
304:
2223:
1850:
1171:
1154:
1116:
944:
4034:
3966:
3230:"'Placebo effect' a concern with controversial MS treatment: Experts"
1906:
639:
635:
372:
368:
288:
261:
222:
1607:
49:
is proposed to be stenosed or have a malformed valve in CCSVI cases.
1825:"Chronic cerebrospinal venous insufficiency and multiple sclerosis"
238:"a growing number of papers that raise serious questions about its
4378:
2949:"Multiple sclerosis pathology: evolution of pathogenetic concepts"
590:
536:
482:
402:
380:
308:
610:
was able to produce similar lesions in dogs blocking their veins
4410:
3138:"MS therapy divides even sufferers, as social media drives hype"
497:
Cardiovascular and Interventional Radiological Society of Europe
364:
91:
3998:
3438:"Ottawa to fund clinical trials for controversial MS treatment"
3389:"CIHR makes recommendations on Canadian MS research priorities"
2922:"Legal fears thwart doctor's bid for 'liberation' from MS pain"
395:, a genetic variation that has been consistently linked to MS.
2046:"CCSVI in Focus at ECTRIMS: New Data but Still Little Clarity"
388:
2848:"New Theory on CCSVI and MS Needs Further Study, Experts Say"
415:
CCSVI was first described using specialized extracranial and
2252:
Primary studies during 2010 on neuroimaging, CCSVI, and MS:
248:. It was agreed that it was urgent to perform appropriate
3920:
Rhodes MA (10 January 2014). Haacke ME, Moore EA (eds.).
1155:"Medical device conflict of interest in the CCSVI debate"
102:
that it might play a role in the cause or development of
524:
that over 30,000 patients have undergone the procedure.
3252:"MS group to fund research into 'liberation procedure'"
3177:. WebMD UK Limited and Boots UK Limited. Archived from
3131:
3129:
3127:
3125:
3123:
3121:
1773:(2). Springer Science and Business Media LLC: 203–214.
1477:
Jagannath VA, Pucci E, Asokan GV, Robak EW (May 2019).
375:
were found to be specifically connected to both MS and
327:
study, and criticism as other researchers found normal
3772:"Italian group offers $ 4.5M to fund new MS research"
1065:
Ferral, Hector; Lorenz, Jonathan M. (13 April 2018).
90:
in 2008 to describe compromised flow of blood in the
3944:
2712:
2710:
2708:
1767:
Current Treatment Options in Cardiovascular Medicine
617:
differentiating healthy individuals from those with
4756:
4691:
4682:
4617:
4577:
4532:
4436:
4418:
4409:
4377:
4337:
4242:
4202:
4179:
4090:
4081:
4051:
4033:
3948:
2039:
2037:
476:Treatment based on the idea of CCSVI is considered
430:
reflux in the internal jugular and vertebral veins,
295:findings in MS. These include risk factors such as
246:"both for and against the controversial hypothesis"
53:
30:
3074:Pullman D, Zarzeczny A, Picard A (February 2013).
1631:Journal of Neurology, Neurosurgery, and Psychiatry
848:Journal of Neurology, Neurosurgery, and Psychiatry
280:have also been reported to contribute to CCSVI. A
197:has been proposed as a possible outcome of CCSVI.
3916:Overview, interviews with proponents and critics.
3164:
3162:
3160:
3158:
383:was connected to both MS and artery passage, and
264:problems in MS patients have been reported to be
3857:Journal of Vascular and Interventional Radiology
3069:
3067:
3065:
3063:
3061:
3059:
3057:
3055:
3053:
3051:
3049:
3047:
2679:Journal of Vascular and Interventional Radiology
1818:
1816:
166:Proposed consequences of CCSVI syndrome include
3518:
3516:
3514:
3512:
3460:
3458:
3045:
3043:
3041:
3039:
3037:
3035:
3033:
3031:
3029:
3027:
2618:
2616:
2543:
2541:
2539:
2537:
2535:
2533:
2531:
2529:
1987:
1985:
1983:
1884:
1882:
1880:
1814:
1812:
1810:
1808:
1806:
1804:
1802:
1800:
1798:
1796:
1670:
1668:
1364:
1362:
1360:
1358:
1356:
1354:
1352:
771:International Society for Neurovascular Disease
1998:Therapeutic Advances in Neurological Disorders
1148:
1146:
1144:
1142:
1098:
1096:
1094:
1092:
1014:
1012:
1010:
1008:
1006:
1004:
837:
835:
833:
831:
829:
827:
825:
4010:
3371:"MS therapy trial urged by Manitoba minister"
2717:Russell P (18 March 2013). Meredith S (ed.).
2554:Journal of Cerebral Blood Flow and Metabolism
1681:Journal of Cerebral Blood Flow and Metabolism
651:of some countries such as the United States.
8:
2750:"Kuwait to offer controversial MS treatment"
2633:CardioVascular and Interventional Radiology
1483:The Cochrane Database of Systematic Reviews
284:component in MS had been cited previously.
86:) is a term invented by Italian researcher
16:"CCVI" redirects here. For other uses, see
4688:
4590:Chronic cerebrospinal venous insufficiency
4415:
4087:
4048:
4017:
4003:
3995:
3945:
3419:"Health minister rejects MS therapy trial"
2067:Lee AB, Laredo J, Neville R (April 2010).
916:
914:
139:United States Food and Drug Administration
76:Chronic cerebrospinal venous insufficiency
64:
36:
31:Chronic cerebrospinal venous insufficiency
27:
3878:
3868:
3609:
3599:
3550:
3540:
3492:
3482:
3101:
3091:
2972:
2822:
2652:
2573:
2453:
2443:
2393:
2383:
2186:
2129:
2017:
1963:
1914:
1840:
1741:
1692:
1502:
1450:
1428:
1332:
1283:
1170:
934:
867:
3209:. Alberta Health Services. 6 August 2010
3018:10.1001/archneurpsyc.1935.02250170015002
1722:Journal of the Royal Society of Medicine
1426:
1424:
1422:
1420:
1418:
1416:
1414:
1412:
1410:
1408:
472:All proposed treatments are experimental
3339:"Premiers jump the gun on MS treatment"
3278:"MS Society's stand sparks resignation"
2677:Interventional Radiology Association".
821:
3393:Canadian Institutes of Health Research
3198:
3196:
1439:Journal of NeuroInterventional Surgery
735:Canadian Institutes of Health Research
4362:Hereditary hemorrhagic telangiectasia
1675:Singh AV, Zamboni P (December 2009).
1472:
1470:
1200:
1198:
805:Pathophysiology of multiple sclerosis
548:percutaneous transluminal angioplasty
7:
4367:Generalized essential telangiectasia
1060:
1058:
707:Multiple Sclerosis Society of Canada
3782:from the original on 12 August 2010
2719:"Study casts doubt on MS treatment"
1570:Paul F, Wattjes MP (January 2014).
512:Society of Interventional Radiology
493:National Multiple Sclerosis Society
3286:. 1 September 2010. Archived from
2965:10.1111/j.1750-3639.2005.tb00523.x
1938:Jedynak W, Cieszanowski A (2014).
14:
3909:"A Controversial 'Cure' for M.S."
3377:. Canadian Press. 16 August 2010.
3357:"Premiers to debate MS treatment"
2774:Melnychuk P (16 September 2010).
1068:Radcases Interventional Radiology
779:International Union of Phlebology
4517:Cerebral venous sinus thrombosis
3529:Patient Preference and Adherence
3395:. 31 August 2010. Archived from
3337:Breakenridge R (4 August 2010).
2506:patients and healthy controls".
775:National CCSVI Society of Canada
221:and degeneration of the nerve's
3686:, media release 8 October 2013.
4468:Hepatic veno-occlusive disease
3830:"CCSVI – current studies"
3684:University of British Columbia
2118:Current Neurovascular Research
1495:10.1002/14651858.CD009903.pub3
759:University of British Columbia
450:It is still not clear whether
1:
4280:Aneurysm of sinus of Valsalva
4134:Monckeberg's arteriosclerosis
3729:. 6 July 2011. Archived from
3651:10.1016/s0140-6736(13)61747-x
3250:Picard A (23 November 2009).
2627:, Barkhof F (February 2011).
2597:Jeffrey S (3 December 2009).
2044:Jeffrey S (3 December 2009).
1588:10.1016/S0140-6736(13)61912-1
1541:10.1016/S0140-6736(13)61747-X
1033:10.1016/S1474-4422(10)70098-3
452:magnetic resonance venography
244:, although evidence had been
4585:Chronic venous insufficiency
4210:Aortoiliac occlusive disease
3907:Tullis P (26 October 2012).
3770:Favaro A (27 January 2010).
3601:10.1371/journal.pone.0072495
3471:BMC Health Services Research
3136:Sinemma J (10 August 2010).
2445:10.1371/journal.pone.0016802
2337:10.1212/WNL.0b013e3181fb44f0
2271:10.1212/WNL.0b013e3181fb449e
2179:10.1212/WNL.0b013e3181d6b125
1325:10.1212/WNL.0000000000006423
1276:10.1001/jamaneurol.2017.3825
1212:Food and Drug Administration
800:Chronic venous insufficiency
236:Already by 2010, there were
4600:Inferior vena cava syndrome
4595:Superior vena cava syndrome
4322:Vertebral artery dissection
4312:Intracranial berry aneurysm
3924:. McFarland Health Topics.
3169:Locke T (12 October 2010).
2811:Journal of Vascular Surgery
1944:Polish Journal of Radiology
1716:Zamboni P (November 2006).
615:sensitivity and specificity
287:Several characteristics of
4812:
4701:Hypertensive heart disease
4352:Arteriovenous malformation
4327:Familial aortic dissection
3870:10.1016/j.jvir.2014.07.024
3359:. CBC News. 2 August 2010.
2920:Agrell S (29 April 2010).
2691:10.1016/j.jvir.2010.07.004
2140:10.2174/156720209788185605
1734:10.1177/014107680609901122
1111:(1): A13-5. January 2010.
572:nerve compression syndrome
15:
4726:Renovascular hypertension
4669:Hepatic artery thrombosis
4317:Carotid artery dissection
4270:Abdominal aortic aneurysm
4120:Intermittent claudication
4083:Peripheral artery disease
3228:Cowan P (6 August 2010).
2891:10.1258/phleb.2010.010053
2824:10.1016/j.jvs.2009.07.096
2748:Favaro A (9 April 2010).
2645:10.1007/s00270-010-0050-5
1779:10.1007/s11936-012-0168-7
1383:10.1007/s10072-010-0458-3
1073:Thieme Medical Publishers
724:Newfoundland and Labrador
562:, stent migration into a
454:, venous angiography, or
44:
35:
4711:Hypertensive nephropathy
4524:Post-thrombotic syndrome
4505:Paget–Schroetter disease
4297:Coronary artery aneurysm
4275:Thoracic aortic aneurysm
3484:10.1186/1472-6963-14-445
3436:Weeks C (29 June 2011).
3171:"CCSVI for MS in the UK"
2947:Lassmann H (July 2005).
2846:Laino C (17 June 2010).
2010:10.1177/1756285613499425
1643:10.1136/jnnp.2008.168179
1452:10.1136/jnis.2010.003947
860:10.1136/jnnp.2008.157164
670:pharmaceutical companies
604:Georg Eduard Rindfleisch
598:described CCSVI in 2008.
4766:Orthostatic hypotension
4748:White coat hypertension
4225:Fibromuscular dysplasia
4189:Carotid artery stenosis
3804:International Angiology
2508:International Angiology
2480:International Angiology
2385:10.1186/1471-2350-11-64
2296:International Angiology
2076:International Angiology
980:International Angiology
893:International Angiology
560:intracranial hemorrhage
361:human leukocyte antigen
183:transpulmonary pressure
4738:Pulmonary hypertension
4721:Secondary hypertension
4716:Essential hypertension
4706:Hypertensive emergency
4547:Portacaval anastomosis
4483:Portal vein thrombosis
4125:Critical limb ischemia
4026:Cardiovascular disease
3093:10.1186/1472-6939-14-6
3006:Arch Neurol Psychiatry
1694:10.1038/jcbfm.2009.180
1153:Stone K (March 2012).
599:
488:
412:
357:copy number variations
177:, reduced drainage of
96:central nervous system
4743:Systolic hypertension
4488:Renal vein thrombosis
4347:Arteriovenous fistula
4339:Vascular malformation
4307:Intracranial aneurysm
4194:Renal artery stenosis
2566:10.1038/jcbfm.2013.31
1371:Neurological Sciences
1021:The Lancet. Neurology
645:conflicts of interest
594:
486:
406:
18:CCVI (disambiguation)
4657:Paradoxical embolism
4652:Cholesterol embolism
4478:May–Thurner syndrome
4473:Budd–Chiari syndrome
4456:Deep vein thrombosis
4451:primarily lower limb
4230:Raynaud's phenomenon
3840:on 23 February 2011.
2776:"Seeking liberation"
2623:Reekers JA, Lee MJ,
2372:BMC Medical Genetics
1873:on 23 November 2010.
630:Conflict of interest
409:transcranial doppler
272:. Problems with the
256:Venous malformations
189:deposits around the
108:liberation procedure
4733:Benign hypertension
3863:(11): 1785–94.e17.
3592:2013PLoSO...872495R
3425:. 2 September 2010.
3399:on 3 September 2010
3318:. 16 September 2010
3290:on 8 September 2010
2817:(6): 1348–58.e1–3.
2436:2011PLoSO...616802W
2212:Annals of Neurology
1956:10.12659/PJR.890379
1829:Annals of Neurology
1319:(18): e1660–e1668.
1159:Annals of Neurology
1105:Annals of Neurology
923:Annals of Neurology
810:Vascular myelopathy
755:catheter venography
697:Reception in Canada
625:Society and culture
533:Balloon angioplasty
433:reflux in the deep
341:Parkinson's disease
337:Alzheimer's disease
333:cerebrospinal fluid
143:balloon angioplasty
47:V.jugularis interna
45:Veins of the neck.
4796:Multiple sclerosis
4647:Pulmonary embolism
4557:Esophageal varices
4495:upper limb / torso
4139:Arteriolosclerosis
3912:The New York Times
3542:10.2147/PPA.S65483
3442:The Globe and Mail
3256:The Globe and Mail
3080:BMC Medical Ethics
2926:The Globe and Mail
1895:Brain and Behavior
1610:on 29 October 2019
677:anecdotal evidence
634:Paolo Zamboni has
619:multiple sclerosis
600:
501:placebo-controlled
495:of the USA or the
489:
456:Doppler sonography
420:doppler sonography
413:
407:Computer-enhanced
278:superior vena cava
195:Multiple sclerosis
133:nor did it have a
112:liberation therapy
104:multiple sclerosis
4791:Vascular diseases
4778:
4777:
4774:
4773:
4618:Arteries or veins
4613:
4612:
4438:Venous thrombosis
4405:
4404:
4387:Cherry hemangioma
4287:Aortic dissection
4238:
4237:
4073:Buerger's disease
3992:
3991:
3931:978-0-7864-8628-1
3745:"UIP self report"
3175:WebMD Health News
2786:on 2 October 2010
2224:10.1002/ana.22067
1851:10.1002/ana.22001
1172:10.1002/ana.23560
1117:10.1002/ana.21969
1082:978-1-62623-283-9
945:10.1002/ana.22001
649:ethical practices
363:focus. Of these,
73:
72:
25:Medical condition
4803:
4689:
4500:Mondor's disease
4443:Thrombophlebitis
4416:
4092:Arteriosclerosis
4088:
4049:
4019:
4012:
4005:
3996:
3946:
3935:
3915:
3893:
3892:
3882:
3872:
3848:
3842:
3841:
3836:. Archived from
3834:mssociety.org.uk
3826:
3820:
3819:
3798:
3792:
3791:
3789:
3787:
3767:
3761:
3760:
3758:
3756:
3747:. Archived from
3741:
3735:
3734:
3719:
3713:
3712:
3710:
3708:
3693:
3687:
3677:
3671:
3670:
3645:(9912): 138–45.
3630:
3624:
3623:
3613:
3603:
3571:
3565:
3564:
3554:
3544:
3520:
3507:
3506:
3496:
3486:
3462:
3453:
3452:
3450:
3448:
3433:
3427:
3426:
3415:
3409:
3408:
3406:
3404:
3385:
3379:
3378:
3367:
3361:
3360:
3353:
3347:
3346:
3334:
3328:
3327:
3325:
3323:
3306:
3300:
3299:
3297:
3295:
3274:
3268:
3267:
3265:
3263:
3247:
3241:
3240:
3238:
3236:
3225:
3219:
3218:
3216:
3214:
3208:
3200:
3191:
3190:
3188:
3186:
3166:
3153:
3152:
3150:
3148:
3133:
3116:
3115:
3105:
3095:
3071:
3022:
3021:
3001:
2995:
2994:
2976:
2944:
2938:
2937:
2935:
2933:
2917:
2911:
2910:
2874:
2868:
2867:
2865:
2863:
2854:. Archived from
2843:
2837:
2836:
2826:
2802:
2796:
2795:
2793:
2791:
2782:. Archived from
2771:
2765:
2764:
2762:
2760:
2745:
2739:
2738:
2736:
2734:
2729:on 29 March 2013
2725:. Archived from
2714:
2703:
2702:
2673:
2667:
2666:
2656:
2620:
2611:
2610:
2608:
2606:
2594:
2588:
2587:
2577:
2545:
2524:
2523:
2502:
2496:
2495:
2475:
2469:
2468:(primary source)
2467:
2457:
2447:
2415:
2409:
2408:(primary source)
2407:
2397:
2387:
2363:
2357:
2356:
2320:
2314:
2311:
2290:
2250:
2244:
2243:
2207:
2201:
2200:
2190:
2158:
2152:
2151:
2133:
2113:
2107:
2106:
2104:
2102:
2096:
2090:. Archived from
2073:
2064:
2058:
2057:
2055:
2053:
2041:
2032:
2031:
2021:
1989:
1978:
1977:
1967:
1935:
1929:
1928:
1918:
1907:10.1002/brb3.297
1886:
1875:
1874:
1869:. Archived from
1844:
1820:
1791:
1790:
1762:
1756:
1755:
1745:
1713:
1707:
1706:
1696:
1672:
1663:
1662:
1626:
1620:
1619:
1617:
1615:
1606:. Archived from
1567:
1561:
1560:
1535:(9912): 138–45.
1523:
1517:
1516:
1506:
1474:
1465:
1464:
1454:
1430:
1403:
1402:
1366:
1347:
1346:
1336:
1304:
1298:
1297:
1287:
1255:
1249:
1248:
1246:
1244:
1230:
1224:
1223:
1221:
1219:
1205:FDA (May 2012).
1202:
1193:
1192:
1174:
1150:
1137:
1136:
1100:
1087:
1086:
1062:
1053:
1052:
1016:
999:
998:
975:
969:
968:
938:
918:
909:
908:
888:
882:
881:
871:
839:
716:British Columbia
691:medical research
135:comparison group
69:
68:
40:
28:
4811:
4810:
4806:
4805:
4804:
4802:
4801:
4800:
4781:
4780:
4779:
4770:
4752:
4678:
4635:Microangiopathy
4630:Macroangiopathy
4609:
4573:
4542:Gastric varices
4528:
4441:
4432:
4401:
4373:
4333:
4265:Aortic aneurysm
4251:
4234:
4220:Erythromelalgia
4198:
4175:
4100:Atherosclerosis
4077:
4041:
4029:
4023:
3993:
3988:
3987:
3957:
3943:
3938:
3932:
3919:
3906:
3902:
3900:Further reading
3897:
3896:
3850:
3849:
3845:
3828:
3827:
3823:
3800:
3799:
3795:
3785:
3783:
3769:
3768:
3764:
3754:
3752:
3743:
3742:
3738:
3733:on 2 July 2013.
3721:
3720:
3716:
3706:
3704:
3695:
3694:
3690:
3678:
3674:
3632:
3631:
3627:
3573:
3572:
3568:
3522:
3521:
3510:
3464:
3463:
3456:
3446:
3444:
3435:
3434:
3430:
3417:
3416:
3412:
3402:
3400:
3387:
3386:
3382:
3369:
3368:
3364:
3355:
3354:
3350:
3336:
3335:
3331:
3321:
3319:
3308:
3307:
3303:
3293:
3291:
3276:
3275:
3271:
3261:
3259:
3249:
3248:
3244:
3234:
3232:
3227:
3226:
3222:
3212:
3210:
3206:
3202:
3201:
3194:
3184:
3182:
3168:
3167:
3156:
3146:
3144:
3135:
3134:
3119:
3073:
3072:
3025:
3003:
3002:
2998:
2953:Brain Pathology
2946:
2945:
2941:
2931:
2929:
2919:
2918:
2914:
2876:
2875:
2871:
2861:
2859:
2852:Neurology Today
2845:
2844:
2840:
2804:
2803:
2799:
2789:
2787:
2780:Bclocalnews.com
2773:
2772:
2768:
2758:
2756:
2747:
2746:
2742:
2732:
2730:
2716:
2715:
2706:
2675:
2674:
2670:
2622:
2621:
2614:
2604:
2602:
2596:
2595:
2591:
2547:
2546:
2527:
2504:
2503:
2499:
2477:
2476:
2472:
2417:
2416:
2412:
2365:
2364:
2360:
2322:
2321:
2317:
2293:
2265:(18): 1617–22.
2255:
2251:
2247:
2209:
2208:
2204:
2160:
2159:
2155:
2131:10.1.1.537.4685
2115:
2114:
2110:
2100:
2098:
2094:
2071:
2066:
2065:
2061:
2051:
2049:
2043:
2042:
2035:
1991:
1990:
1981:
1937:
1936:
1932:
1888:
1887:
1878:
1842:10.1.1.606.8269
1822:
1821:
1794:
1764:
1763:
1759:
1715:
1714:
1710:
1687:(12): 1867–78.
1674:
1673:
1666:
1628:
1627:
1623:
1613:
1611:
1582:(9912): 106–8.
1569:
1568:
1564:
1525:
1524:
1520:
1489:(7): CD009903.
1476:
1475:
1468:
1432:
1431:
1406:
1368:
1367:
1350:
1306:
1305:
1301:
1257:
1256:
1252:
1242:
1240:
1232:
1231:
1227:
1217:
1215:
1204:
1203:
1196:
1152:
1151:
1140:
1102:
1101:
1090:
1083:
1064:
1063:
1056:
1018:
1017:
1002:
977:
976:
972:
936:10.1.1.606.8269
920:
919:
912:
890:
889:
885:
841:
840:
823:
818:
796:
787:
767:
699:
657:
632:
627:
589:
556:
554:Adverse effects
530:
474:
469:
401:
353:
321:
293:epidemiological
274:innominate vein
258:
250:epidemiological
203:
201:Pathophysiology
164:
63:
26:
21:
12:
11:
5:
4809:
4807:
4799:
4798:
4793:
4783:
4782:
4776:
4775:
4772:
4771:
4769:
4768:
4762:
4760:
4754:
4753:
4751:
4750:
4745:
4740:
4735:
4730:
4729:
4728:
4718:
4713:
4708:
4703:
4697:
4695:
4686:
4684:Blood pressure
4680:
4679:
4677:
4676:
4671:
4666:
4661:
4660:
4659:
4654:
4649:
4639:
4638:
4637:
4632:
4621:
4619:
4615:
4614:
4611:
4610:
4608:
4607:
4602:
4597:
4592:
4587:
4581:
4579:
4575:
4574:
4572:
4571:
4566:
4565:
4564:
4559:
4554:
4544:
4538:
4536:
4534:Varicose veins
4530:
4529:
4527:
4526:
4521:
4520:
4519:
4509:
4508:
4507:
4502:
4492:
4491:
4490:
4485:
4480:
4475:
4470:
4460:
4459:
4458:
4447:
4445:
4434:
4433:
4431:
4430:
4424:
4422:
4413:
4407:
4406:
4403:
4402:
4400:
4399:
4397:Spider angioma
4394:
4389:
4383:
4381:
4379:Vascular nevus
4375:
4374:
4372:
4371:
4370:
4369:
4364:
4357:Telangiectasia
4354:
4349:
4343:
4341:
4335:
4334:
4332:
4331:
4330:
4329:
4324:
4319:
4314:
4309:
4299:
4294:
4292:Aortic rupture
4289:
4284:
4283:
4282:
4277:
4272:
4257:
4255:
4253:pseudoaneurysm
4240:
4239:
4236:
4235:
4233:
4232:
4227:
4222:
4217:
4212:
4206:
4204:
4200:
4199:
4197:
4196:
4191:
4185:
4183:
4177:
4176:
4174:
4173:
4172:
4171:
4166:
4164:Oxycholesterol
4161:
4156:
4151:
4146:
4136:
4130:
4129:
4128:
4127:
4122:
4117:
4112:
4107:
4096:
4094:
4085:
4079:
4078:
4076:
4075:
4070:
4069:
4068:
4057:
4055:
4046:
4031:
4030:
4024:
4022:
4021:
4014:
4007:
3999:
3990:
3989:
3986:
3985:
3974:
3958:
3953:
3952:
3950:
3949:Classification
3942:
3941:External links
3939:
3937:
3936:
3930:
3917:
3903:
3901:
3898:
3895:
3894:
3843:
3821:
3793:
3762:
3751:on 18 May 2013
3736:
3714:
3703:. 8 March 2017
3688:
3672:
3625:
3566:
3508:
3454:
3428:
3410:
3380:
3362:
3348:
3343:Calgary Herald
3329:
3301:
3269:
3242:
3220:
3192:
3181:on 8 July 2011
3154:
3142:Calgary Herald
3117:
3023:
3012:(5): 929–940.
2996:
2939:
2912:
2869:
2858:on 8 June 2011
2838:
2797:
2766:
2740:
2704:
2668:
2612:
2589:
2525:
2497:
2470:
2410:
2358:
2331:(18): 1581–2.
2315:
2313:
2312:
2291:
2245:
2202:
2173:(13): 1041–7.
2153:
2108:
2097:on 4 July 2010
2059:
2033:
1979:
1930:
1876:
1792:
1757:
1728:(11): 589–93.
1708:
1664:
1621:
1562:
1518:
1466:
1404:
1348:
1299:
1264:JAMA Neurology
1250:
1225:
1194:
1138:
1088:
1081:
1054:
1000:
970:
910:
883:
820:
819:
817:
814:
813:
812:
807:
802:
795:
792:
786:
783:
766:
763:
698:
695:
656:
653:
631:
628:
626:
623:
588:
585:
576:cranial nerves
555:
552:
529:
526:
473:
470:
468:
465:
448:
447:
444:
441:
438:
435:cerebral veins
431:
400:
397:
352:
349:
331:levels in the
320:
317:
311:and transient
257:
254:
202:
199:
191:cerebral veins
163:
160:
71:
70:
57:
51:
50:
42:
41:
33:
32:
24:
13:
10:
9:
6:
4:
3:
2:
4808:
4797:
4794:
4792:
4789:
4788:
4786:
4767:
4764:
4763:
4761:
4759:
4755:
4749:
4746:
4744:
4741:
4739:
4736:
4734:
4731:
4727:
4724:
4723:
4722:
4719:
4717:
4714:
4712:
4709:
4707:
4704:
4702:
4699:
4698:
4696:
4694:
4690:
4687:
4685:
4681:
4675:
4672:
4670:
4667:
4665:
4662:
4658:
4655:
4653:
4650:
4648:
4645:
4644:
4643:
4640:
4636:
4633:
4631:
4628:
4627:
4626:
4623:
4622:
4620:
4616:
4606:
4603:
4601:
4598:
4596:
4593:
4591:
4588:
4586:
4583:
4582:
4580:
4576:
4570:
4567:
4563:
4560:
4558:
4555:
4553:
4552:Caput medusae
4550:
4549:
4548:
4545:
4543:
4540:
4539:
4537:
4535:
4531:
4525:
4522:
4518:
4515:
4514:
4513:
4510:
4506:
4503:
4501:
4498:
4497:
4496:
4493:
4489:
4486:
4484:
4481:
4479:
4476:
4474:
4471:
4469:
4466:
4465:
4464:
4461:
4457:
4454:
4453:
4452:
4449:
4448:
4446:
4444:
4439:
4435:
4429:
4426:
4425:
4423:
4421:
4417:
4414:
4412:
4408:
4398:
4395:
4393:
4390:
4388:
4385:
4384:
4382:
4380:
4376:
4368:
4365:
4363:
4360:
4359:
4358:
4355:
4353:
4350:
4348:
4345:
4344:
4342:
4340:
4336:
4328:
4325:
4323:
4320:
4318:
4315:
4313:
4310:
4308:
4305:
4304:
4303:
4300:
4298:
4295:
4293:
4290:
4288:
4285:
4281:
4278:
4276:
4273:
4271:
4268:
4267:
4266:
4262:
4259:
4258:
4256:
4254:
4249:
4245:
4241:
4231:
4228:
4226:
4223:
4221:
4218:
4216:
4215:Degos disease
4213:
4211:
4208:
4207:
4205:
4201:
4195:
4192:
4190:
4187:
4186:
4184:
4182:
4178:
4170:
4167:
4165:
4162:
4160:
4157:
4155:
4152:
4150:
4147:
4145:
4142:
4141:
4140:
4137:
4135:
4132:
4131:
4126:
4123:
4121:
4118:
4116:
4113:
4111:
4108:
4106:
4103:
4102:
4101:
4098:
4097:
4095:
4093:
4089:
4086:
4084:
4080:
4074:
4071:
4067:
4064:
4063:
4062:
4059:
4058:
4056:
4054:
4050:
4047:
4045:
4040:
4036:
4032:
4027:
4020:
4015:
4013:
4008:
4006:
4001:
4000:
3997:
3984:
3980:
3979:
3975:
3973:
3969:
3968:
3964:
3960:
3959:
3956:
3951:
3947:
3940:
3933:
3927:
3923:
3918:
3913:
3910:
3905:
3904:
3899:
3890:
3886:
3881:
3880:11392/2284616
3876:
3871:
3866:
3862:
3858:
3854:
3847:
3844:
3839:
3835:
3831:
3825:
3822:
3817:
3813:
3810:(6): 434–51.
3809:
3805:
3797:
3794:
3781:
3777:
3773:
3766:
3763:
3750:
3746:
3740:
3737:
3732:
3728:
3724:
3718:
3715:
3702:
3698:
3692:
3689:
3685:
3681:
3676:
3673:
3668:
3664:
3660:
3656:
3652:
3648:
3644:
3640:
3636:
3629:
3626:
3621:
3617:
3612:
3607:
3602:
3597:
3593:
3589:
3586:(8): e72495.
3585:
3581:
3577:
3570:
3567:
3562:
3558:
3553:
3548:
3543:
3538:
3534:
3530:
3526:
3519:
3517:
3515:
3513:
3509:
3504:
3500:
3495:
3490:
3485:
3480:
3476:
3472:
3468:
3461:
3459:
3455:
3443:
3439:
3432:
3429:
3424:
3420:
3414:
3411:
3398:
3394:
3390:
3384:
3381:
3376:
3372:
3366:
3363:
3358:
3352:
3349:
3344:
3340:
3333:
3330:
3317:
3316:
3311:
3305:
3302:
3289:
3285:
3284:
3279:
3273:
3270:
3257:
3253:
3246:
3243:
3231:
3224:
3221:
3205:
3199:
3197:
3193:
3180:
3176:
3172:
3165:
3163:
3161:
3159:
3155:
3143:
3139:
3132:
3130:
3128:
3126:
3124:
3122:
3118:
3113:
3109:
3104:
3099:
3094:
3089:
3085:
3081:
3077:
3070:
3068:
3066:
3064:
3062:
3060:
3058:
3056:
3054:
3052:
3050:
3048:
3046:
3044:
3042:
3040:
3038:
3036:
3034:
3032:
3030:
3028:
3024:
3019:
3015:
3011:
3007:
3000:
2997:
2992:
2988:
2984:
2980:
2975:
2970:
2966:
2962:
2959:(3): 217–22.
2958:
2954:
2950:
2943:
2940:
2927:
2923:
2916:
2913:
2908:
2904:
2900:
2896:
2892:
2888:
2885:(6): 286–95.
2884:
2880:
2873:
2870:
2857:
2853:
2849:
2842:
2839:
2834:
2830:
2825:
2820:
2816:
2812:
2808:
2801:
2798:
2785:
2781:
2777:
2770:
2767:
2755:
2751:
2744:
2741:
2728:
2724:
2720:
2713:
2711:
2709:
2705:
2700:
2696:
2692:
2688:
2685:(9): 1335–7.
2684:
2680:
2672:
2669:
2664:
2660:
2655:
2650:
2646:
2642:
2638:
2634:
2630:
2626:
2619:
2617:
2613:
2600:
2593:
2590:
2585:
2581:
2576:
2571:
2567:
2563:
2560:(5): 657–68.
2559:
2555:
2551:
2544:
2542:
2540:
2538:
2536:
2534:
2532:
2530:
2526:
2521:
2517:
2514:(2): 127–39.
2513:
2509:
2501:
2498:
2493:
2489:
2486:(2): 109–14.
2485:
2481:
2474:
2471:
2465:
2461:
2456:
2451:
2446:
2441:
2437:
2433:
2430:(2): e16802.
2429:
2425:
2421:
2414:
2411:
2405:
2401:
2396:
2391:
2386:
2381:
2377:
2373:
2369:
2362:
2359:
2354:
2350:
2346:
2342:
2338:
2334:
2330:
2326:
2319:
2316:
2309:
2305:
2302:(2): 149–57.
2301:
2297:
2292:
2288:
2284:
2280:
2276:
2272:
2268:
2264:
2260:
2254:
2253:
2249:
2246:
2241:
2237:
2233:
2229:
2225:
2221:
2217:
2213:
2206:
2203:
2198:
2194:
2189:
2184:
2180:
2176:
2172:
2168:
2164:
2157:
2154:
2149:
2145:
2141:
2137:
2132:
2127:
2123:
2119:
2112:
2109:
2093:
2089:
2085:
2082:(2): 95–108.
2081:
2077:
2070:
2063:
2060:
2047:
2040:
2038:
2034:
2029:
2025:
2020:
2015:
2011:
2007:
2004:(2): 114–36.
2003:
1999:
1995:
1988:
1986:
1984:
1980:
1975:
1971:
1966:
1961:
1957:
1953:
1949:
1945:
1941:
1934:
1931:
1926:
1922:
1917:
1912:
1908:
1904:
1900:
1896:
1892:
1885:
1883:
1881:
1877:
1872:
1868:
1864:
1860:
1856:
1852:
1848:
1843:
1838:
1835:(3): 286–90.
1834:
1830:
1826:
1819:
1817:
1815:
1813:
1811:
1809:
1807:
1805:
1803:
1801:
1799:
1797:
1793:
1788:
1784:
1780:
1776:
1772:
1768:
1761:
1758:
1753:
1749:
1744:
1739:
1735:
1731:
1727:
1723:
1719:
1712:
1709:
1704:
1700:
1695:
1690:
1686:
1682:
1678:
1671:
1669:
1665:
1660:
1656:
1652:
1648:
1644:
1640:
1636:
1632:
1625:
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325:neuroimaging
322:
301:hypertension
297:Epstein-Barr
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260:Most of the
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231:
219:autoimmunity
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181:, increased
168:intracranial
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4302:head / neck
4154:Cholesterol
4044:capillaries
3535:: 1205–13.
3294:5 September
3262:5 September
2052:23 November
1901:(1): 3–12.
1238:www.fda.gov
1165:(3): A6-8.
742:qualitative
710:approved."
505:prospective
179:catabolites
4785:Categories
4674:Vasculitis
4664:Thrombosis
4625:Angiopathy
4569:Varicocele
4562:Hemorrhoid
4392:Halo nevus
4248:dissection
4039:arterioles
3403:9 December
3235:20 October
3213:20 October
3185:14 October
3147:19 October
2879:Phlebology
2723:BootsWebMD
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2605:27 January
2601:. Medscape
2218:(2): 270.
2048:. Medscape
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1218:6 November
816:References
751:ultrasound
568:thrombosis
564:renal vein
528:Procedures
508:randomised
424:ultrasound
345:metabolism
173:, delayed
162:Hypothesis
155:hypothesis
116:venoplasty
98:. Zamboni
60:Cardiology
4428:Phlebitis
4169:Trans fat
4105:Foam cell
4061:Arteritis
4028:(vessels)
3258:. Toronto
2928:. Toronto
2790:4 October
2759:4 October
2353:139095367
2325:Neurology
2259:Neurology
2167:Neurology
2126:CiteSeerX
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1837:CiteSeerX
1787:1092-8464
1604:205970625
1313:Neurology
1189:205343879
1049:206159378
931:CiteSeerX
467:Treatment
399:Diagnosis
270:aneurysms
266:truncular
242:validity"
211:IJV veins
175:perfusion
147:Neurology
55:Specialty
4642:Embolism
4244:Aneurysm
4181:Stenosis
4115:Atheroma
4066:Aortitis
4035:Arteries
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3816:20087280
3780:Archived
3776:CTV News
3701:CBC News
3667:25925875
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3620:23967312
3580:PLOS ONE
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3503:25265935
3423:CBC News
3375:CBC News
3315:CBC News
3112:23402260
2983:16196388
2907:25063737
2899:21107001
2833:19958985
2733:21 March
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905:20351667
878:19060024
794:See also
785:Research
773:and the
537:stenting
517:phase II
385:HLA-DQA2
351:Genetics
329:ferritin
313:ischemia
305:infarcts
282:vascular
240:(CCSVI)
215:stenotic
120:stenting
4463:abdomen
4144:Hyaline
3983:D014689
3755:9 April
3727:Reuters
3707:8 March
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1965:4049975
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1743:1633548
1504:6543952
1334:6207414
1285:5833494
1243:9 March
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720:Alberta
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587:History
546:Venous
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171:hypoxia
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207:azygos
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4261:torso
4203:Other
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2072:(PDF)
1863:S2CID
1655:S2CID
1600:S2CID
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1395:S2CID
1185:S2CID
1129:S2CID
1045:S2CID
966:(MS).
957:S2CID
655:Media
381:TAF11
309:edema
92:veins
80:CCSVI
4512:head
4042:and
3978:MeSH
3926:ISBN
3885:PMID
3812:PMID
3788:2010
3757:2013
3709:2017
3655:PMID
3616:PMID
3557:PMID
3499:PMID
3449:2013
3405:2010
3324:2010
3296:2010
3264:2010
3237:2010
3215:2010
3187:2010
3149:2010
3108:PMID
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2761:2010
2735:2013
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2144:PMID
2103:2010
2084:PMID
2054:2010
2024:PMID
1970:PMID
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1783:ISSN
1748:PMID
1699:PMID
1647:PMID
1616:2019
1592:PMID
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1339:PMID
1290:PMID
1245:2017
1220:2013
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209:and
187:iron
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4159:LDL
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