Percutaneous Transluminal Angioplasty Ineffective in MS
MONDAY, Nov. 27, 2017 -- Percutaneous transluminal angioplasty (PTA) seems to be safe but ineffective for patients with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI), according to a study published online Nov. 18 in JAMA Neurology.
Paolo Zamboni, M.D., from the University of Ferrara Hospital in Italy, and colleagues examined the efficacy and safety of venous PTA in patients with MS and CCSVI. One hundred fifteen patients with relapsing-remitting MS were recruited and randomized to venous PTA (76 patients) or catheter venography without venous angioplasty (sham; 39 patients).
The researchers found that there were no serious adverse events. Fifty-four percent of the PTA group achieved flow restoration. There was no difference in the composite functional measure (walking control, balance, manual dexterity, postvoid residual urine volume, and visual acuity) between the PTA and sham groups (41.7 versus 48.7 percent; odds ratio, 0.75; 95 percent confidence interval, 0.34 to 1.68; P = 0.49). On magnetic resonance imaging, the mean number of combined lesions was 0.47 in the PTA group and 1.27 in the sham group (mean ratio, 0.37; 95 percent confidence interval, 0.15 to 0.91; P = 0.03; adjusted P = 0.09) at six to 12 months and 1.4 versus 1.95 (mean ratio, 0.72; 95 percent confidence interval, 0.32 to 1.63; P = 0.45; adjusted P = 0.45) at zero to 12 months.
"Venous PTA has proven to be a safe but largely ineffective technique; the treatment cannot be recommended in patients with MS," the authors write.
One author was the main author of articles first describing CCSVI and its correlation with MS. Two authors disclosed ties to the pharmaceutical industry.
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Posted: November 2017
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