Can multiple sclerosis be treated with a simple surgical procedure?

That question - raised by the research of an Italian physician - is causing a stir among those who study the condition, which has long been regarded as an autoimmune disease.

Instead, according to Paolo Zamboni, MD, of the University of Ferrara, in Ferrara, Italy, MS may result from poor vascular circulation in the brain.

The theory is this: Abnormal flow through the azygous and jugular venous systems results in a build-up of iron in the brain. The excess iron damages blood vessels and allows the metal, as well as other substances, to cross the blood-brain barrier.

The hypothesis has immediate clinical implications. A simple surgical procedure, a percutaneous transluminal angioplasty, could open the veins and perhaps halt or reverse the course of the disease.

“Most experts regard it as a long shot that needs to be studied,” said John Richert, MD, executive vice president for research and clinical programs at the National Multiple Sclerosis Society.

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