Venous angioplasty in multiple sclerosis

Neurological outcome at two years in a cohort of relapsing-remitting patients

Fabrizio Salvi, Ilaria Bartolomei, Elena Buccellato, Roberto Galeotti, Paolo Zamboni

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

An open study was conducted with the aim of reporting long-term clinical outcome of endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI) in patients with multiple sclerosis (MS). Twenty-nine patients with clinically definite relapsingremitting MS underwent percutaneous transluminal angioplasty for CCSVI, outside a clinical relapse. All the patients were regularly observed over at least two years before the first endovascular treatment and for at least two years after it (mean post-procedure follow up 30.6±6.1 months). The following clinical outcome measures were used: annual relapse rate and Expanded Disability Status Scale (EDSS) score. All the patients were observed intensively (mean 6 hours) on the day of the endovascular treatment to monitor for possible complications (bleeding, shock, heart attack, death). We compared the annual relapse rate before and after treatment (in the two years before and the two years after the first endovascular treatment) and the EDSS score recorded two years before versus two years after the treatment. Overall, 44 endovascular procedures were performed in the 29 patients, without complications. Thirteen of the 29 patients (45%) underwent more than one treatment session because of venous re-stenosis: 11 and two patients underwent two and three endovascular treatments respectively. The annual relapse rate of MS was significantly lower post-procedure (0.45±0.62 vs 0.76±0.99; p=0.021), although it increased in four patients. The EDSS score two years after treatment was significantly lower compared to the EDSS score recorded at the examination two years before treatment (1.98±0.92 vs 2.27±0.93; p=0.037), although it was higher in four patients. Endovascular treatment of concurrent CCSVI seems to be safe and repeatable and may reduce annual relapse rates and cumulative disability in patients with relapsing- remitting MS. Randomized controlled studies are needed to further assess the clinical effects of endovascular treatment of CCSVI in MS.

Original languageEnglish
Pages (from-to)55-59
Number of pages5
JournalFunctional Neurology
Volume27
Issue number1
Publication statusPublished - Jan 2012

Fingerprint

Angioplasty
Multiple Sclerosis
Venous Insufficiency
Recurrence
Therapeutics
Relapsing-Remitting Multiple Sclerosis
Endovascular Procedures
Shock
Pathologic Constriction
Myocardial Infarction
Outcome Assessment (Health Care)
Hemorrhage

Keywords

  • Multiple sclerosis
  • Neurological outcome
  • Venous angioplasty

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Venous angioplasty in multiple sclerosis : Neurological outcome at two years in a cohort of relapsing-remitting patients. / Salvi, Fabrizio; Bartolomei, Ilaria; Buccellato, Elena; Galeotti, Roberto; Zamboni, Paolo.

In: Functional Neurology, Vol. 27, No. 1, 01.2012, p. 55-59.

Research output: Contribution to journalArticle

Salvi, Fabrizio ; Bartolomei, Ilaria ; Buccellato, Elena ; Galeotti, Roberto ; Zamboni, Paolo. / Venous angioplasty in multiple sclerosis : Neurological outcome at two years in a cohort of relapsing-remitting patients. In: Functional Neurology. 2012 ; Vol. 27, No. 1. pp. 55-59.
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