[Chronic cerebrospinal venous insufficiency and multiple sclerosis: a review and update of the subject]

The aetiology of multiple sclerosis remains unknown at the present time, although the most likely explanation is that it has an autoimmune inflammatory origin. During the history of this disease a vascular pathophysiology was once proposed, and it has recently re-emerged as a result of the work by Paolo Zamboni with the name of 'chronic cerebrospinal venous insufficiency'. Following this hypothesis, Zamboni puts forward a curative treatment for multiple sclerosis by means of endovascular treatment of the internal jugular vein and the azygos vein. However, several teams have attempted to replicate his findings without success. In this review, we offer a chronological description of the studies carried out by Zamboni and the later attempts to replicate his work. Our main conclusion is that, given the results we currently have available, we should be cautious and, for the time being, it would be advisable not to recommend the systematic use of this treatment for our patients.