Percutaneous Transluminal Angioplasty for Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: Dichotomy Between Subjective and Objective Outcome Scores

Neurol Sci. 2013 Dec;34(12):2205-10. doi: 10.1007/s10072-013-1450-5. Epub 2013 May 10.

Abstract

Some multiple sclerosis (MS) patients reported an improvement after percutaneous transluminal angioplasty (PTA) for chronic cerebrospinal venous insufficiency (CCSVI), despite the lack of correspondence with objective outcome scores. The objective was to assess neurologic and quality of life scores before and after PTA for CCSVI in an observational study after a self-decided approach. 44 consecutive MS patients (21/23 M/F; median age 43 years, SD 9.8) who underwent PTA were evaluated before endovascular treatment for CCSVI and after 12 months. Neurologic outcome was assessed with EDSS, the annualized relapse rate (ARR) and frequency of new lesions at MRI after PTA. Quality of life was evaluated through the MSQoL-54 questionnaire. No modification in the ARR (p = 0.829), worsening of disability status (p = 0.002) and new lesions at MRI in 29.6 % of patients were found, in contrast to an improvement both in physical and mental domains of MSQoL-54 (p = 0.003). Multiple logistic regression showed EDSS score before PTA to be predictor of an increase of >10 points in MSQoL-54 mental domain (OR 0.52, 95 % CI, 0.31-0.89, p = 0.018). Spontaneously performed approach to CCSVI does not improve clinical and MRI parameters, despite frequent subjective perception of quality of life improvement.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Angioplasty*
  • Brain / blood supply*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / psychology*
  • Multiple Sclerosis / therapy*
  • Quality of Life
  • Spinal Cord / blood supply*
  • Treatment Outcome
  • Venous Insufficiency / complications
  • Venous Insufficiency / psychology*
  • Venous Insufficiency / therapy*