Venous angioplasty in patients with multiple sclerosis: results of a pilot study

Eur J Vasc Endovasc Surg. 2012 Jan;43(1):116-22. doi: 10.1016/j.ejvs.2011.03.035. Epub 2011 Aug 11.


Objectives: Chronic cerebrospinal venous insufficiency (CCSVI) is associated with multiple sclerosis (MS). The objective of the study was to see if percutaneous transluminal angioplasty (PTA) of duplex-detected lesions, of the internal jugular and/or azygous veins, was safe, burdened by a significant restenosis rate, and whether there was any evidence that treatment reduced MS disease activity.

Design: This was a case-control study.

Materials: We studied 15 patients with relapsing-remitting MS and duplex-detected CCSVI.

Methods: Eight patients had PTA in addition to medical therapy (immediate treatment group (ITG)), whereas seven had treatment with PTA after 6 months of medical therapy alone (delayed treatment group (DTG)).

Results: No adverse events occurred. At 1 year, there was a restenosis rate of 27%. Overall, PTA was followed by a significant improvement in functional score compared with baseline (p < 0.02). The annualised relapse rate was 0.12% in the ITG compared with 0.66% in the DTG (p = NS). Magnetic resonance imaging (MRI) blindly demonstrates a trend for fewer T2 lesions in the ITG (p = 0.081), corresponding to a 10% decrease in the ITG compared with a 23% increase in the DTG over the first 6 months of the study.

Conclusions: This study further confirms the safety of PTA treatment in patients with CCSVI associated with MS. The results, despite the significant rate of restenosis, are encouraging and warrant a larger multicentre double-blinded, randomised study.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angioplasty, Balloon* / adverse effects
  • Azygos Vein* / diagnostic imaging
  • Case-Control Studies
  • Chronic Disease
  • Constriction, Pathologic
  • Evidence-Based Medicine
  • Female
  • Humans
  • Italy
  • Jugular Veins* / diagnostic imaging
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis
  • Multiple Sclerosis, Relapsing-Remitting / etiology
  • Multiple Sclerosis, Relapsing-Remitting / therapy*
  • New York
  • Pilot Projects
  • Recurrence
  • Spinal Cord / blood supply*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Diseases / complications
  • Vascular Diseases / diagnosis
  • Vascular Diseases / therapy*
  • Venous Insufficiency / diagnosis
  • Venous Insufficiency / etiology
  • Venous Insufficiency / therapy*
  • Young Adult