title: An endovascular treatment of Chronic Cerebro-Spinal Venous Insufficiency in multiple sclerosis patients - 6 month follow-up results.
abstract: OBJECTIVE
  In this study, the mid-term results (6 month follow-up) of the endovascular treatment in patients with Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) and multiple sclerosis (MS) were prospectively evaluated.
  
  
  METHODS
  Thirty-six patients with confirmed MS and CCSVI underwent endovascular treatment by the means of the uni- or bilateral jugular vein angioplasty with optional stent placement. All the patients completed 6 month follow-up. Their MS-related disability status and quality of life were evaluated 1, 3 and 6 months postoperatively by means of the following scales: Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), Epworth Sleepiness Scale (ESS), Heat Intolerance scale (HIS) and Fatigue Severity Scale (FSS). For patency and restenosis rate assessment, the control US duplex Doppler examination was used.
  
  
  RESULTS
  Six months after the procedure, restenosis in post-PTA jugular veins was found in 33% of cases. Among 17 patients who underwent stent implantation into the jugular vein, restenosis or partial in-stent thrombosis was identified in 55% of the cases. At the 6 month follow-up appointment, there was no significant improvement in the EDSS or the ESS. The endovascular treatment of the CCSVI improved the quality of life according to the MSIS-29 scale but only up to 3 months after the procedure (with no differences in the 6 month follow-up assessment). Six months after the jugular vein angioplasty (with or without stent placement), a statistically significant improvement was observed only in the FSS and the HIS.
  
  
  CONCLUSIONS
  The endovascular treatment in patients with MS and concomitant CCSVI did not have an influence on the patient's neurological condition; however, in the mid-term follow-up, an improvement in some quality-of-life parameters was observed.
authors.affiliation: Department of Surgery, Medical University of Silesia, District Specialist Hospital, Tychy, Poland. kosteckj@op.pl
authors.forename: Jacek
authors.initials: J
authors.lastname: Kostecki
authors.forename: Maciej
authors.initials: M
authors.lastname: Zaniewski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ziaja
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urbanek
authors.forename: Waclaw
authors.initials: W
authors.lastname: Kuczmik
authors.forename: Ewa
authors.initials: E
authors.lastname: Krzystanek
authors.forename: Damian
authors.initials: D
authors.lastname: Ziaja
authors.forename: Tomasz
authors.initials: T
authors.lastname: Korzeniowski
authors.forename: Eugeniusz
authors.initials: E
authors.lastname: Majewski
authors.forename: Marcin
authors.initials: M
authors.lastname: Hartel
authors.forename: Maciej
authors.initials: M
authors.lastname: Swiat
authors.forename: Urszula
authors.initials: U
authors.lastname: Sioma-Markowska
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000628:therapy*; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life; D012894:Sleep Stages; D015607:Stents; D016896:Treatment Outcome; D014690:Venous Pressure; D055815:Young Adult