Chronic cerebrospinal venous insufficiency (CCSVI) is a hypothesis through which 
cerebral venous drainage abnormalities contribute towards the pathogenesis of 
multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report 
the case of a 33-year-old lady with multiple sclerosis who underwent left 
internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring 
open thrombectomy for symptom relief. This occurred without insertion of a stent 
and while fully anticoagulated. Clinicians should be aware that endovenous 
treatment of CCSVI could cause paradoxical deterioration of cerebral venous 
drainage. Patients with complications post venoplasty are now presenting to 
geographically distant vascular units.