OBJECTIVES: Chronic cerebrospinal venous insufficiency (CCSVI) is associated 
with multiple sclerosis (MS). The objective of the study was to see if 
percutaneous transluminal angioplasty (PTA) of duplex-detected lesions, of the 
internal jugular and/or azygous veins, was safe, burdened by a significant 
restenosis rate, and whether there was any evidence that treatment reduced MS 
disease activity.
DESIGN: This was a case-control study.
MATERIALS: We studied 15 patients with relapsing-remitting MS and 
duplex-detected CCSVI.
METHODS: Eight patients had PTA in addition to medical therapy (immediate 
treatment group (ITG)), whereas seven had treatment with PTA after 6 months of 
medical therapy alone (delayed treatment group (DTG)).
RESULTS: No adverse events occurred. At 1 year, there was a restenosis rate of 
27%. Overall, PTA was followed by a significant improvement in functional score 
compared with baseline (p < 0.02). The annualised relapse rate was 0.12% in the 
ITG compared with 0.66% in the DTG (p = NS). Magnetic resonance imaging (MRI) 
blindly demonstrates a trend for fewer T2 lesions in the ITG (p = 0.081), 
corresponding to a 10% decrease in the ITG compared with a 23% increase in the 
DTG over the first 6 months of the study.
CONCLUSIONS: This study further confirms the safety of PTA treatment in patients 
with CCSVI associated with MS. The results, despite the significant rate of 
restenosis, are encouraging and warrant a larger multicentre double-blinded, 
randomised study.