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April 04, 2011
Angioplasty: A Promising Treatment For Multiple Sclerosis?
By Josh Goldstein


Daniel B. Brown, MD

Multiple sclerosis can be a devastating condition that causes some patients to lose their ability to speak, write or walk, while others are affected in relatively minor ways.

And because there is no cure, many MS patients and their families are eager to try promising new treatments, even before those approaches have been fully tested or shown effective.

These days one such approach has many people calling interventional radiologists – those doctors who perform procedures inside the body’s blood vessels. The idea, developed by an Italian doctor, is to open veins in MS patients' necks that are often narrowed, restricting the blood flow out of the brain and back to the heart.

In 2009 Dr. Paulo Zamboni published a paper suggesting the so-called chronic cerebrospinal venous insufficiency (CCSVI) where the major vessels in the brain, the internal jugular and azygous veins are narrowed contributes to MS. Dr. Zamboni suggested that reopening those vessels could improve patients’ symptoms.

After learning about the idea, many MS patients have sought out doctors who would perform angioplasty procedures to open those vessels.

Last week at the annual meeting of the Society of Interventional Radiology in Chicago, several promising reports were issued on the use of angioplasty to treat MS patients.

In one, doctors at the Albany Medical Center in New York released their analysis of 231 patients who underwent angioplasty to widen veins in their necks. The vast majority of those patients (99 percent) were able to go home within 3 hours of their procedure, suggesting that the treatment is safe.

Jefferson interventional radiologist Daniel B. Brown, MD, chief of Interventional Radiology and Interventional Oncology at Jefferson University Hospitals, said that several patients have approached him about the treatment.

“It is a tough situation. Patients are looking for answers,” said Dr. Brown. Still, he noted that it is not yet clear whether the angioplasty procedure truly benefits MS patients. He added if it were a member of his family he would want to make sure they underwent the procedure as part of a prospective randomized clinical trial.

“Right now there isn’t good data on the efficacy,” Dr. Brown said. “I think the best place to do this is in a clinical trial. We need the data. That’s a tough thing to have to tell a patient with MS, which is a devastating disease. These folks need and deserve answers.”

A good start for finding some of those answers is talking to the internationally renowned experts at the Jefferson Comprehensive Multiple Sclerosis Center.