A debate has started over the use of a relatively new surgical procedure as treatment for Multiple Sclerosis (MS) in some hospitals in India. Critics say that the results are not scientifically established and the treatment not approved by regulatory authorities, but doctors are going ahead in the belief that MS, an autoimmune degenerative disorder, can be attributed to vascular reasons.
At least three leading hospitals in different parts of the country have been offering the process, commonly known as ‘liberation therapy’, since June last year. At 170 cases, Medanta Medicity in Gurgaon has handled the largest number of cases. Fortis Hospital in Delhi is next with 38, followed by Apollo, Chennai, with around 12 patients.
Based on Italian physician Dr Paolo Zamboni’s 2009 hypothesis that MS can be attributed to vascular reasons, hospitals argue that it should be treated the same way as in the case of blockages in the heart. Others point out that the long-term effects of such a surgery haven’t been established yet.
Dr Vipul Gupta, senior vascular surgeon at Medanta Medicity who has done a number of such procedures, says Medanta defines the procedure as an “internal study” since the treatment is not yet established, though patients are charged for the procedure.
“Implanting stents for vascular blockages is a routine procedure. Why does it have to be a special case for MS patients?” says Dr Ashok Chordiya, Director of Fortis Noida.
Dr Gupta identifies the condition as “Chronic Cerebrospinal Venous Insufficiency (CCSVI), where blockages caused by iron deposits in veins cut down the blood supply to the brain”. These deposits, he says, are surgically removed by balloon angioplasty, followed by the implantation of a stent. He claims about 30-40 per cent of patients at Medanta have shown short-term improvement.
