Document Detail


Endovascular correction of cerebrovenous anomalies in multiple sclerosis: a retrospective review of an uncontrolled case series.
MedLine Citation:
PMID:  22496109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Endovascular intervention for obstruction to venous drainage of the head and neck is an established treatment for disorders such as superior vena cava syndrome. Some patients with multiple sclerosis have been observed to have anomalies of the veins draining the head and neck. It is possible that some symptoms associated with multiple sclerosis may be secondary to disturbed venous flow. In an uncontrolled clinical series of 40 patients who had been previously diagnosed with multiple sclerosis, anomalies of the venous drainage of the head and neck were observed, including venous stenoses of the internal jugular veins. In 38 of 40 patients, venous stents were placed with restoration of luminal dimensions and abrogation of the venous pressure gradient. The angiographic and hemodynamic improvement was associated with improvement in symptomatology, most particularly in cognitive and constitutional symptoms that may be related to cerebrovenous flow. Serious complications included death in one subject and stent embolization requiring open heart surgery in another. In conclusion, in this series, endovascular intervention to correct venous stenosis associated with multiple sclerosis was associated with improvement in symptoms possibly related to disturbed venous hemodynamics. However, given the serious adverse events in this small series, a randomized clinical trial is required to confirm these findings, and to determine if the procedure has any effect on the progression of multiple sclerosis, or untoward long-term adverse effects.
Authors:
Michael D Dake; Nicholas Dantzker; William L Bennett; John P Cooke
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-10
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  17     ISSN:  1477-0377     ISO Abbreviation:  Vasc Med     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-22     Completed Date:  2012-10-11     Revised Date:  2014-09-16    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty / methods*
Cerebrovascular Disorders / complications,  pathology,  therapy*
Constriction, Pathologic / pathology
Female
Humans
Jugular Veins / pathology
Male
Middle Aged
Multiple Sclerosis / complications,  pathology,  therapy*
Retrospective Studies
Stents
Superior Vena Cava Syndrome / complications,  pathology,  therapy*
Venous Insufficiency / etiology,  pathology,  therapy*
Young Adult
Grant Support
ID/Acronym/Agency:
K12 HL087746/HL/NHLBI NIH HHS; K12 HL087746/HL/NHLBI NIH HHS

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