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Monday, November 22, 2010 8:24 PM
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Ken Torbert
GOTHENBURG, Sweden -- October 17, 2010 -- A
minimally invasive endovascular treatment for chronic cerebrospinal
venous insufficiency (CCSVI) has proven safe and well tolerated in a
small group of patients with multiple sclerosis (MS), according to a
report presented here at the 26th Congress of the European Committee for
Treatment and Research in Multiple Sclerosis (ECTRIMS).
CCSVI is a condition characterised by
multiple strictures at the level of the main extracranial cerebrospinal
venous outflow tracts that may interfere with normal venous drainage.
CCSVI has been implicated in the pathophysiology of MS, but the
association remains unproven and controversial.
A group of 15 patients with MS were
enrolled in a longitudinal pilot study of endovascular treatments
described here on October 14 by Paolo Zamboni, MD, Vascular Diseases
Center, University of Ferrara, Ferrara, Italy.
All subjects had CCSVI as previously
determined by magnetic resonance imaging (MRI) studies, and were treated
with standard disease-modifying MS therapies. Half of the patients
received immediate endovascular treatment and the other half received
delayed endovascular treatment 6 months after study enrolment.
Endovascular treatment consisted of
selective venography of the cerebrospinal vasculature complemented by
percutaneous balloon dilatation when indicated. All patients were
prospectively evaluated with sonography, MRI, and clinical examinations
for up to 12 months following endovascular treatment.
No serious adverse events were observed
during the study. One patient developed a transitory vasovagal syndrome
about 1 hour after endovascular treatment.
Restenosis occurred in 29% of the patients
(2 in the immediate endovascular-treatment group and 2 in the delayed
endovascular-treatment group) between 3 and 12 months after endovascular
treatment. No significant worsening of MRI or clinical features was
observed in either group following endovascular treatment.
The T2 lesion number decreased
significantly in the delayed endovascular-treatment group during the
time between initial study enrolment and the 6-month follow-up after
endovascular treatment (P =.0227).
Additional and larger studies are needed to
determine the potential role of endovascular treatment in the treatment
of patients with MS, Dr. Zamboni concluded.
Funding for this study was provided by Hilarescere Foundation.
[Presentation title: Endovascular
Treatment for Chronic Cerebrospinal Venous Insufficiency in Multiple
Sclerosis. A Longitudinal Pilot Study. Abstract P508]
http://www.docguide.com/news/content.nsf/news/852576140048867C852577BF0072606B?OpenDocument&c=Multiple+Sclerosis&count=10&id=48dde4a73e09a969852568880078c249
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