title: Safety profile of endovascular treatment for chronic cerebrospinal venous insufficiency in patients with multiple sclerosis.
abstract: OBJECTIVE
  To evaluate the safety of endovascular treatment of chronic cerebrovascular insufficiency (CCSVI) in patients with multiple sclerosis (MS).
  
  
  METHODS
  In a 1-year period, 461 MS patients (261 women; mean age 45.4 years, range 21-79) with CCSVI underwent endovascular treatment of 1012 venous lesions during 495 procedures [34 (6.9%) reinterventions]. While balloon angioplasty was preferred, 98 stents were implanted in 76 patients for lesion recoil, restenosis, or suboptimal dilation. The procedures were analyzed for incidences of major adverse events (death, major bleeding, or clinical deterioration of MS), access site complications, procedure-related complications, and procedural safety-related variables (fluoroscopy and contrast times). The complication rates were compared to published data for similar endovascular methods.
  
  
  RESULTS
  There were no deaths, major bleeding events, or clinical deterioration of MS. Access site complications included limited groin hematoma (5, 1.0%); there were no arteriovenous fistulas or puncture site infections. Systemic complications included only rare cardiac arrhythmias (6, 1.2%). Procedure-related complications included vein rupture (2, 0.4%), vein dissection (15, 3.0%), acute in-stent/in-segment thrombosis (8, 1.6%), and acute recoil (1, 0.2%); there was no stent migration or fracture or distal embolization. Mean fluoroscopy time was 22.7 minutes, and mean contrast volume was 136.3 mL.
  
  
  CONCLUSIONS
  Endovascular therapy appears to be a safe and reliable method for treating CCSVI. Innovations such as purpose-specific materials and devices are needed, as are case-controlled and randomized data to establish efficacy in ameliorating MS symptoms.
authors.affiliation: Cardiology Department, Tokuda Hospital Sofia, Bulgaria. petrovivo@hotmail.com
authors.forename: Ivo
authors.initials: I
authors.lastname: Petrov
authors.forename: Lachezar
authors.initials: L
authors.lastname: Grozdinski
authors.forename: Genadi
authors.initials: G
authors.lastname: Kaninski
authors.forename: Nikolai
authors.initials: N
authors.lastname: Iliev
authors.forename: Marjana
authors.initials: M
authors.lastname: Iloska
authors.forename: Angel
authors.initials: A
authors.lastname: Radev
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D001401:Azygos Vein / Q000000981:diagnostic imaging; D002031:Bulgaria; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002908:Chronic Disease; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis; D010690:Phlebography; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013116:Spinal Cord / Q000098:blood supply*; D015607:Stents; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014689:Venous Insufficiency / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult