COMMENTARY Phlebographic Study between Patients withMS and Control Subjects: The Ethical Profile

The term and the concept of chronic cerebrospinal venous in-sufficiency (CCSVI) were coined by the Italian vascular sur-geon Paolo Zamboni, who proposed compromised blood drain-age from the central nervous system in patients with MS, caused by strictures and valves in the major veins of the neck. Very soon after the description in 2009 of CCSVI as themajor, if not unique, causal factor of MS,1 uncontrolled angioplastic or stent placement procedures in the jugular veins, initially termed “libera-tion therapies,”were increasingly offered topatientswith the disease. The “CCSVI community ” grew rapidly on the Web and gained the attention of the media and of the general public. As a result of mis-understandingandoversimplification,notonlypatientswithMSbut also patients with other neurodegenerative disorders such as amyo-trophic lateral sclerosis decided to undergo the angioplastic proce-dure, even if discouraged by their doctors. In their first publication, Zamboni et al1 described venou