Spiral vein graft for internal jugular bypass in a patient with multiple sclerosis and suspected chronic cerebrospinal venous insufficiency

Ann Vasc Surg. 2013 Jul;27(5):673.e5-8. doi: 10.1016/j.avsg.2012.05.033.


Chronic cerebrospinal venous insufficiency (CCSVI) has been implicated as a contributing factor to multiple sclerosis (MS). This theory is strongly debated within the neurology and radiology communities. This report presents the case of a 45-year-old man with known MS and suspected CCSVI who had undergone previous internal jugular angioplasty and stenting. The patient reported dramatic improvement of symptoms after intervention. The stent thrombosed despite antithrombotic medication, and several endovascular interventions failed to restore long-term patency. Open venous reconstruction of the internal jugular vein was performed with a spiral graft from the saphenous vein. The patient's symptoms improved for several weeks until the venous reconstruction occluded. This case is the first reported open venous reconstruction for suspected CCSVI.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty*
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / surgery*
  • Chronic Disease
  • Humans
  • Jugular Veins / surgery*
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / complications*
  • Recurrence
  • Stents
  • Vascular Surgical Procedures / methods*
  • Venous Insufficiency / complications
  • Venous Insufficiency / surgery*