An open study was conducted with the aim of reporting long-term clinical outcome 
of endovascular treatment for chronic cerebrospinal venous insufficiency (CCSVI) 
in patients with multiple sclerosis (MS). Twenty-nine patients with clinically 
definite relapsing-remitting MS underwent percutaneous transluminal angioplasty 
for CCSVI, outside a clinical relapse. All the patients were regularly observed 
over at least two years before the first endovascular treatment and for at least 
two years after it (mean post-procedure follow up 30.6±6.1 months). The 
following clinical outcome measures were used: annual relapse rate and Expanded 
Disability Status Scale (EDSS) score. All the patients were observed intensively 
(mean 6 hours) on the day of the endovascular treatment to monitor for possible 
complications (bleeding, shock, heart attack, death). We compared the annual 
relapse rate before and after treatment (in the two years before and the two 
years after the first endovascular treatment) and the EDSS score recorded two 
years before versus two years after the treatment. Overall, 44 endovascular 
procedures were performed in the 29 patients, without complications. Thirteen of 
the 29 patients (45%) underwent more than one treatment session because of 
venous re-stenosis: 11 and two patients underwent two and three endovascular 
treatments respectively. The annual relapse rate of MS was significantly lower 
post-procedure (0.45±0.62 vs 0.76±0.99; p=0.021), although it increased in four 
patients. The EDSS score two years after treatment was significantly lower 
compared to the EDSS score recorded at the examination two years before 
treatment (1.98±0.92 vs 2.27±0.93; p=0.037), although it was higher in four 
patients. Endovascular treatment of concurrent CCSVI seems to be safe and 
repeatable and may reduce annual relapse rates and cumulative disability in 
patients with relapsing-remitting MS. Randomized controlled studies are needed 
to further assess the clinical effects of endovascular treatment of CCSVI in MS.