ISNVD Abstract Book

Venous Angioplasty In Multiple Sclerosis: Long Term Clinical Outcome Of A Cohort Of Relapsing-Remitting
Patients
Fabrizio Salvi , MD, PhD; Ilaria Bartolomei , MD, PhD; Elena Buccellato , BS; Erica Menegatti , PhD; Roberto
Galeotti , MD; Paolo Zamboni , MD.
Purpose: To report long term clinical outcome of endovascular treatment for chronic cerebrospinal venous
insufficiency (CCSVI) in patients with multiple sclerosis (MS).
Methods: Twenty-nine patients with clinically-definite relapsing remitting MS received percutaneous
transluminal angioplasty for CCSVI at a distance from a clinical relapse and had a regular follow-up extending
at least 2 years both before and after the first endovascular treatment (mean postoperative follow-up 31 months).
Results: Overall 44 endovascular therapy sessions were performed without major complications.
Thirteen of 29 patients (45%) received more than one treatment session because of venous restenosis.
The annual relapse rate of MS was significantly lower postoperatively (0.45+/-0.62 vs 0.76+/-0.99; p=0.021),
but it increased in 4 patients. The Expanded Disability Status Scale (EDSS) 2 years after treatment was
significantly lower compared to the EDSS at the visit obtained 2 years before treatment (1.98+/-0.92 vs 2.27+/-
0.93; p=0.037), but it was increased in 4 patients.
Conclusions: Endovascular treatment of concurrent CCSVI is safe and repeatable and can reduce the annual
relapse rates and the cumulative disability in patients with RR-MS. Randomized controlled studies are needed to
further assess the clinical effects of endovascular treatment of CCSVI in MS.