title: Venous angioplasty in patients with multiple sclerosis: results of a pilot study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  This was a case-control study.
  
  
  METHODS
  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.
authors.affiliation: Vascular Diseases Centre, University of Ferrara, C.so Giovecca 203, 44100 Ferrara, Italy. zmp@unife.it
authors.forename: P
authors.initials: P
authors.lastname: Zamboni
authors.forename: R
authors.initials: R
authors.lastname: Galeotti
authors.forename: B
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.forename: C
authors.initials: C
authors.lastname: Kennedy
authors.forename: F
authors.initials: F
authors.lastname: Salvi
authors.forename: R
authors.initials: R
authors.lastname: Zivadinov
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001401:Azygos Vein / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002908:Chronic Disease; D003251:Constriction, Pathologic; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007558:Italy; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D009518:New York; D010865:Pilot Projects; D012008:Recurrence; D013116:Spinal Cord / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D014689:Venous Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D055815:Young Adult