Impact of Extracranial Veins Endovascular Procedures on the Quality of Life in Patients with Multiple Sclerosis - Follow Up After 1 Year

Abstract

Background: Chronic cerebrospinal venous insufficiency is a new term which highlights the role of extracranial venous anomalies. Stenoses of the jugular and the azygous veins hinder venous drainage and may influence brain perfusion and cerebrospinal fluid flow.

Materials and Methods: In patients with relapsing-remitting and progressive course of multiple sclerosis with a proven obstruction of neck veins percutaneous transluminal angioplasty was performed. We evaluated the clinical disability and quality of life in terms of fatigue, cognitive, psychosocial and bladder dysfunction one year after angioplasty.

Results: In the relapsing-remitting group of patients an improvement of disability was observed, whereas in patients with the progressive course of the disease a stable clinical status was noticed. Both patient groups showed a significant improvement of fatigue. Cognitive and psychosocial impact on the quality of life showed better outcome in patients with advanced course of the disease than in less affected patients. Important amelioration of bladder dysfunction was achieved in both groups.

Conclusion: Endovascular procedures of extracranial venous anomalies demonstrated an encouraging effect in patients with relapsing-remitting and progressive course of the disease. It seems that the removal of vein obstructions improves many non-motor symptoms which importantly contribute to the quality of life in MS patients.

Keywords: Chronic cerebrospinal venous insufficiency; Percutaneous transluminal angioplasty; Clinical disability; Fatigue; Cognitive function; Micturition disturbance



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