Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency in people with multiple sclerosis: a summary of a Cochrane systematic review

Abstract

There is currently no high level evidence to support or refute the efficacy or safety of percutaneous transluminal angioplasty for treatment of CCSVI in people with MS. Clinical practice should be guided by evidence supported by well-designed randomised controlled trials: closure of some of the gaps in the evidence may be feasible at completion of the six ongoing clinical trials.

Social Media Representation of Chronic Cerebrospinal Venous Insufficiency Intervention for Multiple Sclerosis

“…A recent Cochrane systematic review shows that despite the international effort to evaluate the efficacy of CCSVI-related angioplasty and completion of several randomized controlled trials, the evidence does not support or refute the efficacy or safety of the CCSVI-related angioplasty. 4 In this study, 86% of people with MS who uploaded videos reported improvements in at least one area of their functional symptoms. Fatigue and cognition were reported to improve after the CCSVI-related procedure by both people with MS and HCPs.…”

“…The initial research conducted by Zamboni et al 1 identified CCSVI in all patients with MS in the study and in none of the control patients. Despite an international research effort to explore the accuracy of this claim, to date, there remains little to no evidence to support a significant relationship between CCSVI and MS symptoms, [2][3][4] and debate continues. [5][6][7][8] Several randomized controlled trials and systematic reviews have shown no clear evidence for the presence of CCSVI or the effects of suggested surgery.…”

Is the 'liberation procedure' for multiple sclerosis really liberating?

“…In this systematic review summary, van Zuuren and colleagues3 report the results of a systematic review of studies evaluating the effects of PTA in adults with MS who have been diagnosed with CCSVI 4…”

Cerebral Veins-Why Functional MR Imaging is Worth the Trouble

“…Due to the recent experience from several promising trials that have finally failed to show a benefit of interventional compared with medical treatment, [19][20][21] patients with multiple sclerosis should not be treated by venous angioplasty unless the 6 ongoing RCTs prove a clear benefit. 18 Until then, they should consistently receive established (eg, interferons, glatiramer acetate) or newer and more potent drugs (eg, natalizumab, fingolimod, fumaric acid) that have already proved their efficacy and safety in large RCTs.…”

“…At present, to our knowledge, there is no evidence from highlevel randomized controlled trials (RCTs) that has proved the value and safety of percutaneous transluminal venous angioplasty for the treatment of multiple sclerosis. 18 Patients with multiple sclerosis are typically young and closely follow new developments in diagnosis and treatment. Many are very open to undergoing experimental therapies to prevent further progression of disability, even if the efficacy has not yet been proved and if they potentially expose themselves to serious adverse effects.…”