Is CCSVI Treatment a form of surgery?
Posted on 08/26/2011
Through much of the 20th century, the word ‘surgery’ suggested an etherized patient on an operating table partially covered by a white sheet and surrounded by gloved physicians and assistants actively working inside the body with sterilized stainless tools.
This vision, however, captures only a very specific type of "open" surgery. Merriam-Webster more broadly defines surgery as “A branch of medicine concerned with disease or conditions requiring or amenable to operative or manual procedures.” Unfortunately, this broad definition could include everything from chiropractic adjustment to massage therapy.
Surgeons skilled in complex open surgeries may scoff at the notion that comparatively simple endovascular procedures (which don’t even require an incision) are a form of surgery at all. Yet those performing endovascular procedures may refer to themselves as surgeons. Oddly enough, there is no accepted definition of exactly what does and does not constitute surgery. Because of this, CCSVI Alliance will avoid this confusion and refer to the specific technique used, namely, an “endovascular procedure,” or, alternatively, “endovascular surgery.”
Because the patient is awake and aware during the procedure, many physicians will interact with the patient while performing diagnosis and treatment. For example, the physician may ask the patient to "hold your breath now," or "exhale now," in order to help measure blood flow rate or to assess the effects of the treatment. Further, the operating room may have closed-circuit computer or television screens that can show any images the physician has taken from within the vein; patients can sometimes watch the inside of their veins during the procedure.
Two CCSVI treatment types are common: balloon angioplasty and stenting.
In balloon angioplasty, the vein is opened or widened by inflating a cylindrically-shaped balloon inside the vein for short period of time. The balloon, which is near the tip of the catheter, is moved into the area of stenosis and inflated. The balloon is often inflated and deflated several times in order to ensure the desired degree of patency. When inflated, the balloon is capable of extreme rigidity, allowing it to open or clear even difficult blockages. Once all stenoses have been cleared (as possible), the balloon is deflated and, together with the catheter, drawn back through the veins and out of the body.
Stenting is performed in the same manner as angioplasty. However, stenting uses a slightly different catheter (called a “stent-delivery” catheter). A stent is a manufactured metal-mesh tube that is attached near the end of the catheter so that it can be placed inside the vein and opened. Like angioplasty, the stent is used to clear or open blockages. Stent placement is considered a more permanent solution than angioplasty, but it carries some additional risks.
Once the blockages have been opened or cleared (as much as possible), the catheter is removed, and the physician’s primary work is done.
