Article Citation:

Ivo Petrov, Lachezar Grozdinski, Genadi Kaninski, Nikolai Iliev, Marjana Iloska and Angel Radev (2011) Safety Profile of Endovascular Treatment for Chronic Cerebrospinal Venous Insufficiency in Patients With Multiple Sclerosis. Journal of Endovascular Therapy: June 2011, Vol. 18, No. 3, pp. 314-323.

doi: 10.1583/11-3440.1

VENOUS INTERVENTIONS

Safety Profile of Endovascular Treatment for Chronic Cerebrospinal Venous Insufficiency in Patients With Multiple Sclerosis

Ivo Petrov, MD, PhD, Lachezar Grozdinski, MD, PhD, Genadi Kaninski, MD, Nikolai Iliev, MD, Marjana Iloska, MD, and Angel Radev, MD

Cardiology Department, Tokuda Hospital Sofia, Bulgaria

Abstract

Purpose: 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.

Conclusion: 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.

Keywords: venous insufficiency, multiple sclerosis, balloon angioplasty, stent, endovascular treatment, safety

The authors have no commercial, proprietary, or financial interest in any products or companies described in this article.

Address for correspondence and reprints: Ivo Petrov, Cardiology Department, Tokuda Hospital Sofia, 51 B Nikola Vaptsarov Blvd., 1407 Sofia, Bulgaria. E-mail: petrovivo@hotmail.com

Cited by

Marian Simka. (2011) COMMENTARY: Safety of Endovascular Treatment for CCSVI and Future Perspectives. Journal of Endovascular Therapy 18:3, 326-327

Online publication date: 1-Jun-2011.

Citation | Full Text | PDF (105 KB) 

Donald B. Reid. (2011) COMMENTARY: Significance of the Internal Jugular Vein in the Treatment of Cerebrovascular Insufficiency. Journal of Endovascular Therapy 18:3, 324-325

Online publication date: 1-Jun-2011.

Citation | Full Text | PDF (32 KB)