Presentation Time: 2:00 PM - 2:00 PM

Pres. No.: P-504 - Initial experience treating chronic cerebro spinal venous insufficiency (CCSVI): preliminary results in 15 patients

G. Eisele, C. Schulte, M. Cannellotto, D. Simonelli, P. Perez Leguizamon 

Buenos Aires/AR 

Purpose:

To evaluate feasibility, tolerance and initial response to balloon angioplasty in patients with multiple sclerosis (MS) and imaging confirmed CCSVI. 

Material and Methods:

Fifteen patients with MS (8 women) were selected for this treatment (7 relapsing-remitting, 8 secondary progressive). After informed consent, the evaluation consisted in neurologic (EDSS, MSIS 29, fatigue, heat tolerance and sleepiness scale), laboratory and cervical color Doppler ultrasound (CDU) tests. Internal jugular veins (IJV), azygos phlebography and manometry were performed with standard technique previous to angioplasty.

Initial follow-up from 3 months consisted in neurologic and CDU control. 

Complications described were related to angioplasty. Definitions include: positive, absent and mixed response. 

Results:

Angioplasty was feasible in 15 cases and 3 patients suffered minor complications without neurologic effect. CDU showed 2 Zamboni´s criteria of CCSVI in most of the affected IJV and excellent phlebographic correlation in 27/30 studied IJVs. Four, 6 and 5 patients had phlebographic Zamboni´s type 

A, B and C.

Before treatment, patients presented with mean EDSS scores of 5.5 to 6 and 10 of them improved scores in scales after angioplasty at 3 months. Seven over 26 treated IJVs had restenosis in 6 patients. One case 

had positive response despite restenosis, 3 patients relapsed neurologic disabilities after angioplasty. The other 2 patients did not reply to angioplasty. 

Conclusion:

CCSVI has close relation with MS and venous angioplasty can be used safely with excellent tolerance to improve MS symptoms. In some patients, disabilities relief after balloon angioplasty may be limited because of restenosis and/or other still unknown mechanism.