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Acta Phlebologica 2018 August;19(2):47-8

DOI: 10.23736/S1593-232X.18.00416-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Multiple sclerosis: is the Brave Dreams Study a tombstone for CCSVI and eventual surgical procedures? An open discussion

Pietro M. BAVERA 1, 2, 3

1 Vascular Surgeon and Diagnostician for Medick-Up Vascular Lab, Milan, Italy; 2 Italian Society for Angiology and Vascular Medicine (SIAPAV), Rome, Italy; 3 Italian Society for Vascular Investigation (SIDV), Rome, Italy



The results of a recent article published in JAMA Neurology regarding the conclusions of Brave Dreams (BD) Study, “Efficacy and Safety of Extracranial Vein Angioplasty in Multiple Sclerosis a Randomized Clinical Trial”, disappointed for a multitude of reasons. It was closed after almost five years and missing enrolment of 315 multiple sclerosis (MS) patients, out of the initially intended 430, the conclusions could therefore turn out to be a sort of statistical hazard. All conclusions are significant when numbers are big otherwise the results may be weak. This is mathematical, and it is precisely the case of the BD Study. The authors affirm some good scientific results that do not match with JAMA Neurology Editor’s final considerations applied to chronic cerebrovascular vein insufficiency (CCSVI) treatment in the whole. The Editor’s conclusions lead against jugular percutaneous transluminal angioplasty (PTA) treatment efficacy in MS patients, sustaining uselessness, but they differ from the clinical reality that we daily see in our professional practice.


KEY WORDS: Multiple sclerosis - Jugular veins - Venous insufficiency

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