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Endovascular Treatment for Chronic Cerebrospinal Venous Insufficiency in Patients with Multiple Sclerosis

Marian Simka, MD1, Piotr Janas, MD1, Tomasz Ludyga, MD1, Paweł Latacz, MD2, Marek Kazibudzki, MD1

ABSTRACT: Objective. The aim of this study was to evaluate the impact of endovascular treatment for chronic cerebrospinal venous insufficiency on chronic fatigue in multiple sclerosis patients.

Methods. Severity of fatigue was measured with Fatigue Severity Scale (FSS) in 340 patients before the treatment and after 6-month follow-up.

Results. We found statistically significant improvement of fatigue. After the treatment, mean FSS score dropped from 4.7 to 3.8. However, these post-procedural changes were not evenly distributed. While the patients with no fatigue (FSS<2.0) or mild/moderate fatigue (FSS 2.0-3.9) did not report significantly changed fatigue, the patients with severe fatigue (FSS≥4.0) experienced a statistically significant drop of FSS scores, which in this subgroup was 1.21. Such variables as the patients’ gender, age, duration of the disease, or localization of vascular lesions did not influence the level of postprocedural improvement of fatigue.

Conclusion. Our results confirm the findings of the previous studies that have found a positive effect of endovascular treatment on chronic fatigue in multiple sclerosis patients. Despite all limitations of our study, improved fatigue, especially when severe, appears to be an encouraging finding, which warrants further study in this area.