May 2012

Angioplasty, MS, Hope, and Science
By Jim Knaub
Radiology Today
Vol. 13 No. 5 P. 3

What do recent reports suggesting that angioplasty of neck veins reduces symptoms in 50% to 60% of patients with multiple sclerosis (MS) mean? They mean controversy. That’s how it is with chronic cerebrospinal venous insufficiency (CCSVI) these days. That’s how it usually is when a devastating, incurable disease meets a new treatment that shows some startling anecdotal results.

MS is an incurable, progressive, debilitating disease affecting an estimated 400,000 in the United States and 2.5 million worldwide. Interventional radiologists attending the recent Society of Interventional Radiology annual meeting presented measured, encouraging data on angioplasty for relieving symptoms in MS based on the concept of CCSVI. Some MS patients have seen tremendous symptom improvement, presumably—though nothing is proven—because the angioplasty improves blood flow out of the brain. Our article on recent data on angioplasty for CCSVI appears on page 24.

Hector Ferral, MD, reported data from 94 MS patients. In that series, 55% of patients reported symptom improvement, and 38% reported no improvement. (Seven percent were lost to follow-up.) I consider that encouraging data from early ongoing research on the topic.

Here’s what it’s up against: “Your life changes. In 30 minutes to an hour you feel completely different. I feel like my life has started again. I feel like my whole body—my mind, my shoulders, my back—has completely changed.”

This quote comes from a YouTube video in which a man identified as Costas Andreou discussed the CCSVI angioplasty he received in Bulgaria. Andreou said he struggled to walk because of weak legs and could not stand up straight before the treatment. Andreou talked about how he felt three days after treatment. I found his video in less than a minute using Google; you can be certain the MS community knows all about it. Advocacy groups are pushing for broader use of the treatment.

Ferral and others like him are working with hospital institutional review boards on to studies to learn more about CCSVI, MS, and angioplasty’s role in treatment. They hope for an investigational device exemption and clinical trials in the not-too-distant future. One objective will be to learn more about the CCSVI concept that could help doctors determine which MS patients are more likely to be helped by the procedure. It is good news, but hope doesn’t want to wait for the results of a controlled clinical trial.

Enjoy the issue.