http://download.journals.elsevierhealth ... 014424.pdf
QOL and EDSS Variations after Percutaneous Transluminal Angioplasty in
170 MS Patients with CCSVI.
Purpose: In spite of the lack of confirmed data on the real value of transluminal
angioplasty for the treatment of multiple sclerosis (MS) symptoms in patients with
positive chronic cerebrospinal venous insufficiency (CCSVI) after an ultrasound duplex
scan, many patients have received angioplasty treatment in several countries. The
purpose of this study is to evaluate the patient’s perceived improvement of quality of
life (QOL) after angioplasty using the QOL scale and independent objective evaluation
using expanded disability status scale (EDSS).
Materials and Methods: Since October 2010, >380 MS patients with an ultrasound
color duplex scan of CCSVI underwent jugular and azygos percutaneous transluminal
angioplasty in our institution. There were 170 patients of this series evaluated before
the treatment and then after 1 and 3 months. The median age of patients was 34 years
and median EDSS was 4.5 (minimum, 3; maximum, 8 ). An independent physician (not
neurologist, but experienced general practitioner) evaluated the disability scale using the
EDSS scale; and the patients completed a 16-item questionnaire (QOL questionnaire),
which provided a score from 7 (best) to 1 (worst). The questionnaire was collected and
saved anonymously, and in random order.
Results: We calculated the median EDSS value of the 170 patients before the treatment,
after 1 month, and after 3 months; values were 4.5,, and 4, respectively, with bigger
variations on subtypes (severe EDSS demonstrated minor changes). QOL averages
demonstrated a total score of 640 before percutaneous transluminal angioplasty, a score
of 696 after 1 month, and a score of 710 after 3 months; bigger variations on lesser
disability were noted. We are collecting data on 6-month follow-up.
Conclusions: We conclude that MS patients with a diagnosis of CCSVI who are
treated with angioplasty can obtain a slight improvement on disability scale, especially
in EDSS below 7, and somewhat improves the patient’s perceived QOL scale at least
for a 3-month period after the treatment. A longer observation time and a control group
are strongly needed to confirm these data.