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J Endovasc Ther. 2011 Jun;18(3):314-23.

Safety profile of endovascular treatment for chronic cerebrospinal venous insufficiency in patients with multiple sclerosis.

Petrov I, Grozdinski L, Kaninski G, Iliev N, Iloska M, Radev A.
SourceCardiology Department, Tokuda Hospital Sofia, Bulgaria.

Abstract

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.

J Endovasc Ther. 2011 Jun ;18 (3):326-7 21679069
COMMENTARY: Safety of Endovascular Treatment for CCSVI and Future Perspectives.
Marian Simka
Department of Vascular and Endovascular Surgery, Euromedic Specialist Clinics, Katowice, Poland.

J Endovasc Ther. 2011 Jun ;18 (3):324-5 21679068
COMMENTARY: Significance of the Internal Jugular Vein in the Treatment of Cerebrovascular Insufficiency.
Donald B Reid
The Edinburgh Clinic, Edinburgh, Scotland, UK.

Commentaries are by Dr. Simka and Dr. Reid but not accessible without a subscription.

Dr Petrov will give a reading of his paper at the NYC Symposium on July 17.
there will be reviews of several completed studies and discussion of designs of others that are in progress or soon to start, including Brave Dreams