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Endovascular treatment of CCSVI in patients with multiple sclerosis: clinical outcome of 462 cases

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Abstract

Although it is still debated whether chronic cerebro-spinal venous insufficiency (CCSVI) plays a role in multiple sclerosis (MS) development, many patients underwent endovascular treatment (ET) of CCSVI. The objective of the study is to evaluate the outcome and safety of ET in Italian MS patients. Italian MS centers that are part of the Italian MS Study Group were all invited to participate to this retrospective study. A structured questionnaire was used to collect detailed clinical data before and after the ET. Data from 462 patients were collected in 33 centers. ET consisted of balloon dilatation (93 % of cases) or stent application. The mean follow-up duration after ET was 31 weeks. Mean EDSS remained unchanged after ET (5.2 vs. 4.9), 144 relapses occurred in 98/462 cases (21 %), mainly in RR-MS patients. Fifteen severe adverse events were recorded in 3.2 % of cases. Given the risk of severe adverse events and the lack of objective beneficial effects, our findings confirm that at present ET should not be recommended to patients with MS.

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Authors and Affiliations

  1. Centro Studi Sclerosi Multipla, Ospedale di Gallarate, Gallarate, Italy

    A. Ghezzi, P. Annovazzi & A. Bianchi

  2. Centro Sclerosi Multipla, Dipartimento di Sanità Pubblica, Medicina Clinica e Molecolare, University of Cagliari, Cagliari, Italy

    E. Cocco

  3. Centre for Experimental Neurological Therapies (CENTERS), Neurology and Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University S. Andrea Hospital-Rome, Rome, Italy

    G. Coarelli

  4. Multiple Sclerosis Center, Department of Neuroscience and Imaging, Università “G d’Annunzio” Chieti, Chieti, Italy

    A. Lugaresi

  5. Multiple Sclerosis Center, Fondazione Don Gnocchi, Milan, Italy

    M. Rovaris

  6. DANA GF Ingrassia, Neuroscience Section, Multiple Sclerosis Center, University of Catania, Catania, Italy

    F. Patti

  7. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Liguria, Italy

    E. Capello

  8. Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

    M. E. Rodegher, L. Moiola & G. Comi

  9. Neurologia 2-CRESM, AOU San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Turin, Italy

    S. Malucchi

  10. Centro per la “Diagnosi e Cura delle Malattie Demielinizzanti” Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Università degli Studi di Palermo, Palermo, Italy

    G. Salemi

  11. U.S.D Neurologia, Centro Regionale per la Sclerosi Multipla, Spedali Civili Brescia, Presidio di Montichiari, Montichiari, Italy

    N. De Rossi

  12. Clinica Neurologica, Università Politecnica delle Marche, Ancona, Italy

    L. Provinciali

  13. Neurological Department, Azienda Ospedaliera Università’ di Padova, 30128, Padua, Italy

    P. Perini

  14. Centro di Ricerca Interdipartimentale per la Sclerosi Multipla (CRISM), Istituto Neurologico Nazionale ‘C. Mondino’, Pavia, Italy

    R. Bergamaschi

  15. Clinica Neurologica, Fondazione Cà Granda Ospedale Policlinico, Milan, Italy

    E. Scarpini

  16. First Division of Neurology, Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy

    G. Lus

  17. II Clinica Neurologica, Dip.to di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell’Invecchiamento, Seconda Università di Napoli, Naples, Italy

    A. Gallo

  18. Unità Operativa di Neurologia Azienda Ospedaliero, Universitaria S. Anna Ferrara, Ferrara, Itlay

    M. R. Tola

  19. Department of Neurosciences, University of Florence, Florence, Italy

    M. P. Amato

  20. Dipartimento di Chirurgia del Sistema Nervoso e Neuroscienze, Multiple Sclerosis Center, Ospedali Riuniti Bergamo, Bergamo, Italy

    M. R. Rottoli

Authors
  1. A. Ghezzi
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  2. P. Annovazzi
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  3. E. Cocco
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  4. G. Coarelli
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  5. A. Lugaresi
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  6. M. Rovaris
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  7. F. Patti
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  8. E. Capello
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  9. M. E. Rodegher
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  10. L. Moiola
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  11. S. Malucchi
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  12. G. Salemi
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  13. N. De Rossi
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  14. L. Provinciali
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  15. P. Perini
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  16. R. Bergamaschi
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  17. E. Scarpini
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  18. G. Lus
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  19. A. Gallo
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  20. M. R. Tola
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  21. M. P. Amato
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  22. M. R. Rottoli
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  23. A. Bianchi
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  24. G. Comi
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Consortia

The MS Study Group-Italian Society of Neurology

Corresponding author

Correspondence to A. Ghezzi.

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Ghezzi, A., Annovazzi, P., Cocco, E. et al. Endovascular treatment of CCSVI in patients with multiple sclerosis: clinical outcome of 462 cases. Neurol Sci 34, 1633–1637 (2013). https://doi.org/10.1007/s10072-013-1300-5

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  • DOI: https://doi.org/10.1007/s10072-013-1300-5

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