Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central 
nervous system (CNS) by an unknown pathogenesis. MR venography and postmortem 
studies have demonstrated a topographic correspondence between multiple 
sclerosis (MS) plaques and the cerebral venous system pathology. In recent 
observational studies performed on patients from distinctive gene pools, the 
prevalence of chronic cerebrospinal venous insufficiency (CCSVI) in MS ranged 
from 56% to 100%. Endovascular treatment (percutaneous transluminal angioplasty 
(PTA) with or without stenting) of CCSVI was reported to be feasible with a 
minor complication rate. In 4 patients with different forms of multiple 
sclerosis venography was performed that revealed stenosis of the proximal region 
of the jugular vein (right or left). Percutaneous transluminal balloon 
angioplasty (PTA) was performed in all patients. There were no complications and 
mean stenosis was reduced after PTA from 59.75% to 36.75%. Follow-up included 
clinical observations and magnetic resonance imaging (MRI). In all the cases we 
observed positive remission of the disease, the first ever documented case of 
MRI index improvement. PTA seems to be an effective treatment for patients with 
CCVI and multiple sclerosis, However, randomized studies are warranted to 
establish the efficacy of this new treatment for MS.