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Correl CCSVI Venogramation of localization and severity of extra-cranial venous lesions with clinical status of multiple sclerosis

Background:
Chronic cerebrospinal venous insufficiency is suspected to play a role in pathogenesis of multiple sclerosis.

Objective:
Assessment of the correlations between patterns of venous lesions and clinical characteristics of multiple sclerosis.

Methods:
Localization and degree of venous blockages in multiple sclerosis 381 patients were evaluated using catheter venography. Analysis of clinical severity included: Multiple Sclerosis Impact Scale-29 (MSIS-29), chronic fatigue and heat intolerance assessment.

Results:
Venous blockages were found in 97.1% of the patients.
Abnormalities were more severe in older patients. No correlation existed between duration of the disease and severity of venous pathologies. Patients with younger age at onset of multiple sclerosis presented with milder venous lesions. Significant correlations existed between severity and localization of venous lesions and clinical burden in terms of MSIS-29 and chronic fatigue scores, but not of heat intolerance.

Conclusion:
Prevalence of chronic cerebrospinal venous insufficiency among multiple sclerosis patients is very high. Indirect data analysis indicated that venous abnormalities are probably congenital, slowly progress, but are unlikely to be caused by multiple sclerosis.
Their severity and localization significantly modify clinical course of this disease. However, they are not likely to directly trigger multiple sclerosis, but there may be another factor initiating the disease.

Simka M, Ludyga T, Kazibudzki M, Latacz P,
?wierad M, Piegza J
1. Zamboni P, Galeotti R, Menegatti E, et al. Chronic cerebrospinal venous insufficiency in patients with MS. J Neurol Neurosurg Psychiatry 2009;80:392-9.
2. Simka M. Blood brain barrier compromise with endothelial inflammation may lead to autoimmune loss of myelin during multiple sclerosis. Curr Neurovasc Res 2009;6:132-9.
3. Lee BB, Bergan J, Gloviczki P. et al. Diagnosis and treatment of venous malformations Consensus Document of the International uni0n of Phlebology (IUP)-2009. Int Angiol 2009;28:434-51.
4. Zamboni P, Menegatti E, Galeotti R, et al. The value of cerebral Doppler venous haemodynamics in the assessment of MS. J Neurol Sci 2009;282:21-7.
5. Zamboni P, Menegatti E, Bartolomei I, et al. Intracranial venous haemodynamics in MS. Curr Neurovasc Res 2007;4:252-8.
6. Zamboni P, Consorti G, Galeotti R, et al. Venous collateral circulation of the extracranial cerebrospinal outflow routes. Curr Neurovasc Res 2009;6:204-2.
7. Simka M, Kostecki J, Zaniewski M, Majewski E, Szewczyk-Urgacz D. Preliminary report on pathologic flow patterns in the internal jugular and vertebral veins of patients with multiple sclerosis. Przegl Flebol 2009;17:61-4.
8. Simka M, Kostecki J, Zaniewski M, Majewski E, Hartel M. Extracranial Doppler sonographic criteria of chronic cerebrospinal venous insufficiency in the patients with multiple sclerosis. Int Angiol 2010; 29:109-14.
9. Zamboni P, Galeotti R, Menegatti E, et al. Endovascular treatment of chronic cerebrospinal venous insufficiency, A prospective open-label study. J Vasc Surg 2009;6:1348-58.
10. Embry AF. Intergating CCSVI and CNS autoimmunity in a disease model for MS. Int Angiol 2010; 29:93-4.
11. Lee BB, Laredo J, Neville R. Embryological background of truncular venous malformation in the extracranial venous pathways as the cause of chronic cerebrospinal venous insufficiency. Int Angiol 2010; 29:95108.
12. Al-Omari MH, Rousan LA. Jugular vein morphology and hemodynamics in patients with multiple sclerosis. Int Angiol 2010; 29:115-20.
13. Menegatti E, Genova V, Tessari M, et al. The reproducibility of colour Doppler in chronic cerebrospinal venous insufficiency associated with multiple sclerosis. Int Angiol2010; 29:121-6.
14. Hojnacki D, Zamboni P, Lopez-Soriano A. et al. Use of Neck megnetic resonance venography for diagnosis of chronic cerebrospinal venous insufficiency: a pilot study in multiple sclerosis patients and healthy controls. Int Angiol 2010; 29:127-39.
15. Weinshenker BG, Bass B, Rice GP, et al. The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. Brain 1989; 112:133-46.
16. Bartolomei I, Salvi F, Galeotti R, et al. Hemodynamic pattern of chronic cerebrospinal venous insufficiency in multiple sclerosis. Correlation with symptoms at onset and clinical course. Int Angiol 2010; 29:183-8.
17. Sclafani S. Chronic cerebrospinal venous insufficiency: a new paradigm and therapy for multiple sclerosis. Endovascular Today 2010; July:41-46.
18. Sundström P, Wåhlin A, Ambarki K, Birgander R, Eklund A, Malm J. Venous and cerebrospinal fluid flow in multiple sclerosis: A case-control study. Ann Neurol 2010; 68:255-9.
19. Doepp F, Friedemann P, Valdueza JM, Schmierer K, Schreiber SJ. No
cerebrocervical venous congestion in patients with multiple sclerosis. Ann Neurol 2010; 68:173-83.
20. Confavreux C, Vukusic S. Natural history of multiple sclerosis: a unifying concept. Brain 2006; 129:606-16.
21. Ludyga T, Kazibudzki M, Simka M, et al. Endovascular treatment for chronic cerebrospinal venous insufficiency: is the procedure safe? Phlebology 2010 (article in press)
22. Zaniewski M, Kostecki J, Ziaja K. et al. Endovascular burgery for the treatment of symptoms of multiple sclerosis. Preliminary report. Chir Pol 2010; 12:12-7.
23. Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A. The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain 2001;124:962-73.
24. Flachenecker P, Kümpfel T, Kallmann B, et al. Fatigue in multiple sclerosis: a comparison of different rating scales and correlation to clinical parameters. Mult Scler 2002;8:523-6.
25. Chaudhuri A, Behan PO. Multiple sclerosis: looking beyond autoimmunity. J Roy Soc Med 2005;98:303-306.
26. Simka M, Zaniewski M. Reinterpreting the magnetic resonance signs of hemodynamic impairment in the brains of multiple sclerosis patients from the perspective of a recent discovery of outflow block in the extracranial veins. J Neurosc Res 2010;88:1841-5.
EUROMEDIC Specialist Clinics, Department of Vascular & Endovascular Surgery, Katowice; Poland.
References:

Source:
Euromedic Specialist Clinics (31/08/10)

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