vn_charing_cross_2009-lowres.pdf
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Multiple sclerosis and the cerebral venous system
At the Charing Cross Symposium on Monday 6 April, Paolo Zamboni (pictured), University of Ferrara, Italy, will present the rationale behind and promising preliminary results of an endovascular technique for the treatmentof multiple sclerosis. According to Zamboni, a topographic correspondence between multiple sclerosis plaques and the cerebral venous system has been demonstrated, and in histological studies characteristic signs of impaired venous drainage – such as perivenous iron deposits and fibrin cuffs – are evident.
Zamboni notes an abnormal cerebral venous outflow in 86% of multiple sclerosis sufferers participating in this study associated with the azygous vein. The authors performed 77 balloon angioplasty procedures to treat identified venous obstructive lesions under local anesthesia. Patients who underwent this procedure were followed up by means of a validated clinical test for investigating the motility of upper and lower extremities as well as cognitive function (the multiple sclerosis functional composite), then expanded disability status scale, Expanded Standard Disability Status Scale,and a recognised quality of life questionnaire (MSQoL-54), in addition to clinical and magnetic resonance imaging assessment. The venous patency and its relationship with the clinical course was also evaluated.
) I am hoping that as more and more of us are having this success with the treatment it becomes more of a moot point. 
