Subcommittee on Neurological Disease committee  The problem, however, is the number of people who are adequately trained to do the duplex imaging of patients with CCSVI is small. There are currently three technicians trained in Canada by Zamboni to do the procedure. There is a fourth who lives in Niagara Falls and works in Buffalo. That's it. That's all you have.

Subcommittee on Neurological Disease committee  Dr. McDonald, who will make the decision whether or not to image for CCSVI in Canada? What criteria have to be met? What timeline are we looking at? What is stopping you from performing this procedure today?

Subcommittee on Neurological Disease committee  Many people do not believe that treating the jugular vein or the azygous vein will improve the symptom complex, and on this basis, different bodies are telling us we can't do it. For instance, in Quebec, the college said they didn't think we should be imaging for CCSVI in patients. Why, I don't know. Why the decision was made, I don't know, but I believe that decision came down roughly a week ago.

Subcommittee on Neurological Disease committee  Since there was discussion about the science, Dr. McDonald, I'm wondering if you can talk to us about the science of CCSVI. Is it a recognized condition? By whom? What are the guidelines for diagnosis and treatment?

Subcommittee on Neurological Disease committee  Sometimes the justification can come from clinical observation and sometimes it can come from experimental observation on animal and tissue culture models. For instance, we all know—and this has some analogies to CCSVI—that coronary angioplasty and coronary stenting is a routine, accepted procedure. But people forget to stop and think about what our knowledge about coronary angiography has derived from.

Subcommittee on Neurological Disease committee  We have a doctor in Barrie, Sandy McDonald, who is one of the top vascular surgeons, who has been working directly on the CCSVI possibility. I know he's very excited about the possibilities there as well. To follow up on a point that Megan Leslie mentioned first, in terms of your statement about the leading cause of death, is that something that we are anticipating we'll find out through the study?

Subcommittee on Neurological Disease committee  The recommendations for funding of research applications come through panels that are assembled for various competitions. In the context of the CCSVI competition, obviously that panel was assembled with the expertise that is relevant to that kind of research, and I note as well that we were the first to launch a competition. Our sister organization, the American MS society, launched a similar competition, and we have assembled a joint panel, an international one that includes European expertise and expertise from both the U.S. and Canada.

Subcommittee on Neurological Disease committee  To look at the requests from both the American and Canadian research competitions in MS. Sorry, it's CCSVI.

Subcommittee on Neurological Disease committee  Thank you, Mr. Malo. That is a very important question. The funding is for research on CCSVI, obviously in relation to multiple sclerosis. The reason why are making this request is because this is urgent. Urgent action is required. The Quebec College of Physicians is one of the organizations that has decided not to make this treatment available, out of a need and concern for more evidence of its effectiveness.

Subcommittee on Neurological Disease committee  You're here as an individual, and there were lots of folks coming together on the Hill. There is certainly a grassroots campaign happening about CCSVI, but is there a coming together as one group? Is there an organization forming that can be a conduit for us in talking about these issues, or is it still mostly individuals coming together in the beginning stages?

Subcommittee on Neurological Disease committee  If you ask the question of colleagues of yours who are physicians and researchers, they will tell you the evidence available for CCSVI, including the protocols for imaging, is in the early stages. That is why a number of medical associations, provincial bodies, and the Alberta Health Services Board have made the decision to not make available what is still an experimental treatment, in their view.

Subcommittee on Neurological Disease committee  Does the society recognize the consensus document of the International Union of Phlebology that has come out from the expert panel representing 47 countries, which recognizes venous malformations and how to diagnose and treat them? That includes CCSVI.