Patients with multiple sclerosis who undergo the minimally invasive endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI) may experience significant symptom relief that results in short-term improvement in their quality of life, according to two studies presented at the Society of Interventional Radiology’s 37th Annual Scientific Meeting in San Francisco, Calif.
In one study, researchers from the Albany Medical Center in Albany, NY, analyzed questionnaire responses received from192 MS patients: 96 with had relapsing remitting MS, 66 with secondary progressive MS , and 30 with primary progressive MS. The majority of the patients underwent angioplasty alone and three underwent angioplasty with a stent placement. The questionnaire reviewed key quality of life components, including changes in physical abilities, health perception, energy and fatigue, sexual function, emotional well-being, cognition, and pain, said Meridith J. Englander, MD, one of the study’s co-authors.
“Results of the study were quite exciting and promising,” said Kenneth Mandato, MD, an interventional radiologist. “We can attest to significant physical improvements reported in greater than 75 percent of those with relapse remitting and primary progressive forms of multiple sclerosis. Additionally, mental health scores improved in greater than 70 percent of individuals studied. People with secondary progressive multiple sclerosis showed statistically significant improvements in both physical and mental health scores at a rate of 59 percent and 50 percent, respectively.”
How long the patients had MS did appear to play a role in response to treatment, however. “We found a trend that patients undergoing this treatment more than 10 years after diagnosis did not respond as well as those with more recent diagnosis,” noted Englander.
The second study, a retrospective review of 105 angioplasty procedures (35 men and 59 women), with stenting if required, produced similar findings. The patients had relapsing remitting MS (50 percent), secondary progressive MS (39 percent), primary progressive MS (6.4 percent) or unknown (4.2 percent).
The results were encouraging, researchers said. Fifty-five percent reported at least some improvement in their symptoms, 38 percent reported no improvements, and seven were lost to follow-up. The patients who reported the best results (nearly 60 percent) were those with relapsing remitting MS.
“These important results revealed that, for people with multiple sclerosis who experience debilitating symptoms, minimally invasive interventional radiology treatments can be an effective, palliative treatment that may also improve their quality of life,” said Hector Ferral, MD, an interventional radiologist at NorthShore University HealthSystem in Evanston, Ill.
More studies are needed to evaluate the role of angioplasty for patients with MS, researchers said. “As we are still early in fully understanding the condition and its relation to treatment of CCSVI,” Mandato said, “it is our hope that future double-blinded prospective studies will be performed to further assess the durability of these results.”