Percutaneous Venous Angioplasty in Patients with Multiple Sclerosis and Chronic Cerebrospinal Venous Insufficiency: A Randomized Wait List Control Study.
Ann Vasc Surg
; 62: 275-286, 2020 Jan.
Article
en En
| MEDLINE
| ID: mdl-31445091
ABSTRACT
BACKGROUND:
Venous percutaneous transluminal angioplasty (vPTA) in patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI) have shown contradictory results. The aim of the study is to evaluate the efficacy of the procedure in a randomized wait list control study.METHODS:
66 adults with neurologist-confirmed diagnosis of MS and sonographic diagnosis of CCSVI were allocated into vPTA-yes group (n = 31) or vPTA-not group (n = 35, control group). vPTA was performed immediately 15 days after randomization in the PTA-yes group and 6 months later in the control group. Evoked potentials (EPs), clinical-functional measures (CFMs), and upper limb kinematic measures (ULKMs) were measured at baseline (T0) and six months after in both groups, just before the venous angioplasty in the vPTA-not group (T1).RESULTS:
Comparing the vPTA-yes and vPTA-not group, the CFM-derived composite functional outcome showed 11 (37%) versus 7 (20%) improved, 1 (3%) versus 3 (8%) stable, 0 versus 7 (20%) worsened, and 19 (61%) versus 18 (51%) mixed patients (χ2 = 8.71, df = 3, P = 0.03). Unadjusted and adjusted (for baseline confounding variables) odds ratio at 95% confidence interval were, respectively, 1.93 (1.3-2.8), P value 0.0007, and 1.85 (1.2-1.7), P value 0.002. EP- and ULKM-derived composite functional outcome showed no significant difference between the two groups.CONCLUSIONS:
Venous angioplasty can positively impact a few CFMs especially for the quality of life but achieving disability improvement is unlikely.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Insuficiencia Venosa
/
Venas Cerebrales
/
Trastornos Cerebrovasculares
/
Angioplastia
/
Esclerosis Múltiple Crónica Progresiva
/
Esclerosis Múltiple Recurrente-Remitente
/
Extremidad Superior
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Humans
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ann Vasc Surg
Asunto de la revista:
ANGIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Italia