Chronic cerebrospinal venous insufficiency (CCSVI) has been implicated as a 
contributing factor to multiple sclerosis (MS). This theory is strongly debated 
within the neurology and radiology communities. This report presents the case of 
a 45-year-old man with known MS and suspected CCSVI who had undergone previous 
internal jugular angioplasty and stenting. The patient reported dramatic 
improvement of symptoms after intervention. The stent thrombosed despite 
antithrombotic medication, and several endovascular interventions failed to 
restore long-term patency. Open venous reconstruction of the internal jugular 
vein was performed with a spiral graft from the saphenous vein. The patient's 
symptoms improved for several weeks until the venous reconstruction occluded. 
This case is the first reported open venous reconstruction for suspected CCSVI.