Venous angioplasty in patients with multiple sclerosis: results of a pilot study.
Eur J Vasc Endovasc Surg
; 43(1): 116-22, 2012 Jan.
Article
in En
| MEDLINE
| ID: mdl-21839654
ABSTRACT
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord
/
Azygos Vein
/
Vascular Diseases
/
Venous Insufficiency
/
Angioplasty, Balloon
/
Multiple Sclerosis, Relapsing-Remitting
/
Jugular Veins
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
/
Europa
Language:
En
Journal:
Eur J Vasc Endovasc Surg
Journal subject:
ANGIOLOGIA
Year:
2012
Type:
Article
Affiliation country:
Italy