PURPOSE: To evaluate the safety of outpatient endovascular treatment in patients 
with multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency 
(CCSVI).
MATERIALS AND METHODS: A retrospective analysis was performed to assess 
complications occurring within 30 days of endovascular treatment of CCSVI. The 
study population comprised 240 patients; 257 procedures were performed over 8 
months. The indication for treatment in all patients was symptomatic MS. Of the 
procedures, 49.0% (126 of 257) were performed in a hospital, and 51.0% (131 of 
257) were performed in the office. Primary procedures accounted for 93.0% (239 
of 257) of procedures, and repeat interventions accounted for 7% (18 of 257). 
For patients treated primarily, 87% (208 of 239) had angioplasty, and 11% (26 of 
239) had stent placement; 5 patients were not treated. Of patients with 
restenosis, 50% (9 of 18) had angioplasty, and 50% (9 of 18) had stent 
placement.
RESULTS: After the procedure, all but three patients were discharged within 3 
hours. Headache after the procedure was reported in 8.2% (21 of 257) of 
patients; headache persisted > 30 days in 1 patient. Neck pain was reported in 
15.6% (40 of 257); 52.5% (21 of 40) of these patients underwent stent placement. 
Three patients experienced venous thrombosis requiring retreatment within 30 
days. Sustained intraprocedural arrhythmias were observed in three patients, and 
two required hospital admission. One of these patients, who was being retreated 
for stent thrombosis, was hospitalized because of a stress-induced 
cardiomyopathy.
CONCLUSIONS: Endovascular treatment of CCSVI is a safe procedure; there is a 
1.6% risk of major complications. Cardiac monitoring is essential to detect 
intraprocedural arrhythmias. Ultrasonography after the procedure is recommended 
to confirm venous patency and to identify patients experiencing acute venous 
thrombosis.