CASE REPORT   

Italian Journal of Vascular and Endovascular Surgery 2017 December;24(4):169-72

DOI: 10.23736/S1824-4777.17.01304-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Surgical repair of PTA-related internal jugular vein occlusion in multiple sclerosis: report of four cases with chronic cerebrospinal venous insufficiency

Luciano BARBATO ¹ ✉, Massimo CONTI ², Maria A. GRASSO ³, Filippo SCALISE ⁴, Salvatore SPAGNOLO ¹

¹ Department of Cardiovascular Surgery, Maria Pia Hospital, Turin, Italy; ² Cardiovascular Rehabilitation Institute, Camogli, Genoa, Italy; ³ Department of Cardiovascular Surgery, Istituto Clinico Ligure di Alta Specialità (ICLAS), Rapallo, Genoa, Italy; ⁴ Cardiac and Vascular Catheterization Laboratory, Monza Polyclinic, Monza, Italy

In some patients with chronic cerebrospinal venous insufficiency (CCSVI) and multiple sclerosis (MS), restoration of a normal venous flow pattern by internal jugular veins (IJV) angioplasty (PTA) has been shown to improve neurological status and functional capacity. However, whenever present, the beneficial effects of PTA are usually transient and often associated with serious vascular complications, especially when the procedure is completed with vascular stent implantation. We report here four cases of CCSVI and MS with different degrees of disability, who recently came to our observation. In all, a previous internal jugular vein PTA had produced severe vascular damage and symptoms relapse. Successful surgical repair re-established long-term vessel patency and significantly improved neurological symptoms. Whichever the role of CCSVI MS patients, PTA does not appear to represent a viable solution while surgery is almost invariably feasible and safe and grants a more durable result in terms of vessels patency and symptomatic improvement.

KEY WORDS: Venous insufficiency - Stents - Thrombosis