Although using angioplasty to treat multiple sclerosis is highly controversial, sufferers often insist it helps—in some cases dramatically, such as allowing them to walk without assistance. Patients with less-severe multiple sclerosis also reported additional quality of life improvements, such as being able to talk more clearly, after having treatment to open blocked blood vessels in the chest and neck, according to research presented at the International Symposium on Endovascular Therapy (ISET), 19–23 January 2013, Miami, Florida, USA.
A controversial theory holds that multiple sclerosis symptoms may be caused by narrowed veins leading away from the brain, which interrupts blood flow between the brain and heart. This condition, called chronic cerebrospinal venous insufficiency (CCSVI), is treated with minimally invasive angioplasty to open up those narrowed veins. In the research presented at ISET, more than 65% patients treated for CCSVI report quality of life improvements three months after treatment.
“The patients reported improvement in common multiple sclerosis symptoms such as brain fog, frozen extremities, dizziness, bladder control and speech, and over time, they continued to improve,” said Marco Magnano, professor of interventional radiology at the Residency of Vascular Surgery of University of Catania, Sicily. “Although this could be due to the placebo effect, you have to wonder how that alone could help patients get out of the wheelchair, or forgo a cane or crutches.”
In the study, 170 patients were evaluated using the expanded disability status scale (EDSS), a standard method used to quantify the level of disability in multiple sclerosis patients. Using the EDSS, patients rank their symptoms from 0 to 10 (higher numbers indicating more severe disability.) Prior to treatment, the patients in the study averaged 4.5, meaning they had some limitation of activity and were able to walk without resting for slightly more than 300 yards. Three months after treatment, they improved to an average of 4.0, meaning they were up and about 12 hours a day and able to walk without resting for more than 500 yards. The patients who initially scored higher on the disability scale were less likely to improve.
The EDSS focuses on physical abilities, therefore the multiple sclerosis patients also filled out a questionnaire to gauge their quality of life, including participation in activities such as reading, recreation and socialising. Patients answered each of 16 quality of life questions with answers ranging from 1 to 7 (the higher score indicating better quality of life). Out of a total possible score of 112, patients overall improved from 64 before treatment to 70 after one month and 71 after three months. Six-month follow up in 77 patients suggests the benefits may wane, but scores remain better than they were before treatment.
“In about a quarter of the cases, the treated veins restenose which correlates with symptoms worsening again and suggests this condition is valid,” said Magnano. “More studies are necessary, but it is certainly premature to discount this treatment for multiple sclerosis.”