PURPOSE: To investigate characteristics of cine phase contrast-calculated 
cerebrospinal fluid (CSF) flow and velocity measures in patients with 
relapsing-remitting (RR) multiple sclerosis (MS) receiving standard medical 
treatment who had been diagnosed with chronic cerebrospinal venous insufficiency 
(CCSVI) and underwent percutaneous transluminal angioplasty (PTA).
MATERIALS AND METHODS: This case-controlled, magnetic resonance (MR) 
imaging-blinded study included 15 patients with RR MS who presented with 
significant stenoses (≥50% lumen reduction on catheter venography) in the 
azygous or internal jugular veins. Eight patients underwent PTA in addition to 
medical therapy immediately following baseline assessments (case group) and 
seven had delayed PTA after 6 months of medical therapy alone (control group). 
CSF flow and velocity measures were quantified over 32 phases of the cardiac 
cycle by a semiautomated method. Outcomes were compared between groups at 
baseline and at 6 and 12 months of the study by mixed-effect model analysis.
RESULTS: At baseline, no significant differences in CSF flow or velocity 
measures were detected between groups. At month 6, significant improvement in 
flow (P<.001) and velocity (P = .013) outcomes were detected in the immediate 
versus the delayed group, and persisted to month 12 (P = .001 and P = .021, 
respectively). Within-group flow comparisons from baseline to follow-up showed a 
significant increase in the immediate group (P = .033) but a decrease in the 
delayed group (P = .024). Altered CSF flow and velocity measures were associated 
with worsening of clinical and MR outcomes in the delayed group.
CONCLUSIONS: PTA in patients with MS with CCSVI increased CSF flow and decreased 
CSF velocity, which are indicative of improved venous parenchyma drainage.