Skip to main content
Top
Published in: Neurological Sciences 9/2013

01-09-2013 | Original Article

Endovascular treatment of CCSVI in patients with multiple sclerosis: clinical outcome of 462 cases

Authors: A. Ghezzi, P. Annovazzi, E. Cocco, G. Coarelli, A. Lugaresi, M. Rovaris, F. Patti, E. Capello, M. E. Rodegher, L. Moiola, S. Malucchi, G. Salemi, N. De Rossi, L. Provinciali, P. Perini, R. Bergamaschi, E. Scarpini, G. Lus, A. Gallo, M. R. Tola, M. P. Amato, M. R. Rottoli, A. Bianchi, G. Comi, The MS Study Group-Italian Society of Neurology

Published in: Neurological Sciences | Issue 9/2013

Login to get access

Abstract

Although it is still debated whether chronic cerebro-spinal venous insufficiency (CCSVI) plays a role in multiple sclerosis (MS) development, many patients underwent endovascular treatment (ET) of CCSVI. The objective of the study is to evaluate the outcome and safety of ET in Italian MS patients. Italian MS centers that are part of the Italian MS Study Group were all invited to participate to this retrospective study. A structured questionnaire was used to collect detailed clinical data before and after the ET. Data from 462 patients were collected in 33 centers. ET consisted of balloon dilatation (93 % of cases) or stent application. The mean follow-up duration after ET was 31 weeks. Mean EDSS remained unchanged after ET (5.2 vs. 4.9), 144 relapses occurred in 98/462 cases (21 %), mainly in RR-MS patients. Fifteen severe adverse events were recorded in 3.2 % of cases. Given the risk of severe adverse events and the lack of objective beneficial effects, our findings confirm that at present ET should not be recommended to patients with MS.
Appendix
Available only for authorised users
Literature
1.
go back to reference Zamboni P (2006) The big idea: iron-dependent inflammation in venous disease and proposed parallels in multiple sclerosis. J R Soc Med 99:589–593PubMedCrossRef Zamboni P (2006) The big idea: iron-dependent inflammation in venous disease and proposed parallels in multiple sclerosis. J R Soc Med 99:589–593PubMedCrossRef
2.
go back to reference Zamboni P, Menegatti E, Bartolomei I et al (2007) Intracranial venous haemodynamics in multiple sclerosis. Curr Neurovasc Res 4:252–258PubMedCrossRef Zamboni P, Menegatti E, Bartolomei I et al (2007) Intracranial venous haemodynamics in multiple sclerosis. Curr Neurovasc Res 4:252–258PubMedCrossRef
3.
go back to reference Zamboni P, Galeotti R, Menegatti E et al (2009) Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 80:392–399PubMedCrossRef Zamboni P, Galeotti R, Menegatti E et al (2009) Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 80:392–399PubMedCrossRef
4.
go back to reference Zamboni P, Menegatti E, Galeotti R et al (2009) The value of cerebral Doppler venous haemodynamics in the assessment of multiple sclerosis. J Neurol Sci 282:21–27PubMedCrossRef Zamboni P, Menegatti E, Galeotti R et al (2009) The value of cerebral Doppler venous haemodynamics in the assessment of multiple sclerosis. J Neurol Sci 282:21–27PubMedCrossRef
5.
go back to reference Thapar A, Lane T, Nicholas R, Friede T et al (2011) Systematic review of sonographic chronic cerebrospinal venous insufficiency findings in multiple sclerosis. Phlebology 26(8):319–325PubMedCrossRef Thapar A, Lane T, Nicholas R, Friede T et al (2011) Systematic review of sonographic chronic cerebrospinal venous insufficiency findings in multiple sclerosis. Phlebology 26(8):319–325PubMedCrossRef
6.
go back to reference Baracchini C, Atzori M, Gallo P (2012) CCSVI and MS: no meaning, no fact. Neurol Sci May 9 (Epub ahead of print) Baracchini C, Atzori M, Gallo P (2012) CCSVI and MS: no meaning, no fact. Neurol Sci May 9 (Epub ahead of print)
7.
go back to reference Bagert BA, Marder E, Stüve O (2011) Chronic cerebrospinal venous insufficiency and multiple sclerosis. Arch Neurol 68:1379–1384PubMedCrossRef Bagert BA, Marder E, Stüve O (2011) Chronic cerebrospinal venous insufficiency and multiple sclerosis. Arch Neurol 68:1379–1384PubMedCrossRef
8.
go back to reference Kipshidze N, Rukhadze I, Archvadze A et al (2011) Endovascular treatment of patients with chronic cerebrospinal venous insufficiency and multiple sclerosis. Georgian Med News 199:29–34PubMed Kipshidze N, Rukhadze I, Archvadze A et al (2011) Endovascular treatment of patients with chronic cerebrospinal venous insufficiency and multiple sclerosis. Georgian Med News 199:29–34PubMed
9.
go back to reference Mandato KD, Hegener PF, Siskin GP et al (2012) Safety of endovascular treatment of chronic cerebrospinal venous insufficiency: a report of 240 patients with multiple sclerosis. J Vasc Interv Radiol 23:55–59PubMedCrossRef Mandato KD, Hegener PF, Siskin GP et al (2012) Safety of endovascular treatment of chronic cerebrospinal venous insufficiency: a report of 240 patients with multiple sclerosis. J Vasc Interv Radiol 23:55–59PubMedCrossRef
10.
go back to reference Kostecki J, Zaniewski M, Ziaja K et al (2011) An endovascular treatment of chronic cerebro-spinal venous insufficiency in multiple sclerosis patients—6 month follow-up results. Neuro Endocrinol Lett 32:557–562PubMed Kostecki J, Zaniewski M, Ziaja K et al (2011) An endovascular treatment of chronic cerebro-spinal venous insufficiency in multiple sclerosis patients—6 month follow-up results. Neuro Endocrinol Lett 32:557–562PubMed
11.
go back to reference Zamboni P, Galeotti R, Weinstock-Guttman B et al (2012) Venous angioplasty in patients with multiple sclerosis: results of a pilot study. Eur J Vasc Endovasc Surg 43:116–122PubMedCrossRef Zamboni P, Galeotti R, Weinstock-Guttman B et al (2012) Venous angioplasty in patients with multiple sclerosis: results of a pilot study. Eur J Vasc Endovasc Surg 43:116–122PubMedCrossRef
12.
go back to reference Petrov I, Grozdinski L, Kaninski G (2011) Safety profile of endovascular treatment for chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Endovasc Ther 18:314–323PubMedCrossRef Petrov I, Grozdinski L, Kaninski G (2011) Safety profile of endovascular treatment for chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Endovasc Ther 18:314–323PubMedCrossRef
13.
go back to reference Ludyga T, Kazibudzki M, Simka M et al (2010) Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe? Phlebology 25:286–295PubMedCrossRef Ludyga T, Kazibudzki M, Simka M et al (2010) Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe? Phlebology 25:286–295PubMedCrossRef
14.
go back to reference Zamboni P, Galeotti R, Menegatti E et al (2009) A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency. J Vasc Surg 50:1348–1358PubMedCrossRef Zamboni P, Galeotti R, Menegatti E et al (2009) A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency. J Vasc Surg 50:1348–1358PubMedCrossRef
15.
go back to reference Salvi F, Bartolomei I, Buccellato E et al (2012) Venous angioplasty in multiple sclerosis: neurological outcome at two years in a cohort of relapsing-remitting patients. Funct Neurol 27:55–59PubMed Salvi F, Bartolomei I, Buccellato E et al (2012) Venous angioplasty in multiple sclerosis: neurological outcome at two years in a cohort of relapsing-remitting patients. Funct Neurol 27:55–59PubMed
17.
go back to reference Kurtzke JF (1983) Rating neurological impairment in multiple sclerosis: an expanded disability scale (EDSS). Neurology 33:1444–1452PubMedCrossRef Kurtzke JF (1983) Rating neurological impairment in multiple sclerosis: an expanded disability scale (EDSS). Neurology 33:1444–1452PubMedCrossRef
18.
go back to reference Ghezzi A. Annovazzi P, Amato MP et al. (2013) Adverse events after endovascular treatment of chronic cerebrospinal venous insufficiency (CCSVI) in patients with multiple sclerosis Mult Scler J (in press) Ghezzi A. Annovazzi P, Amato MP et al. (2013) Adverse events after endovascular treatment of chronic cerebrospinal venous insufficiency (CCSVI) in patients with multiple sclerosis Mult Scler J (in press)
Metadata
Title
Endovascular treatment of CCSVI in patients with multiple sclerosis: clinical outcome of 462 cases
Authors
A. Ghezzi
P. Annovazzi
E. Cocco
G. Coarelli
A. Lugaresi
M. Rovaris
F. Patti
E. Capello
M. E. Rodegher
L. Moiola
S. Malucchi
G. Salemi
N. De Rossi
L. Provinciali
P. Perini
R. Bergamaschi
E. Scarpini
G. Lus
A. Gallo
M. R. Tola
M. P. Amato
M. R. Rottoli
A. Bianchi
G. Comi
The MS Study Group-Italian Society of Neurology
Publication date
01-09-2013
Publisher
Springer Milan
Published in
Neurological Sciences / Issue 9/2013
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-013-1300-5

Other articles of this Issue 9/2013

Neurological Sciences 9/2013 Go to the issue