PURPOSE: This study proposed to prospectively evaluate safety and clinical 
changes in outpatient endovascular treatment in patients with multiple sclerosis 
(MS) and chronic cerebrospinal venous insufficiency (CCSVI).
MATERIALS AND METHODS: Two hundred fifty-nine patients with MS were followed 
with the Multiple Sclerosis Impact Scale (MSIS-29) before and for 1 and 6 months 
after treatment of extracranial internal jugular vein and azygos vein stenoses 
and occlusions using venous angioplasty, as well as stent placement in 2.5% of 
patients. Before treatment, the patients were tested with magnetic resonance 
(MR) venography and flow quantification.
RESULTS: We found statistically significant improvements in the MSIS-29 scores 
(P < .01) at both 1 and 6 months. At 1 and 6 months, 67.9% and 53.6% were 
improved on the physical scale, respectively, and 53.0% and 44.4% were improved 
on the psychological scale, respectively. Women showed greater improvement than 
did men on the physical scale at 6 months (P = .01). Patients with primary 
progressive MS (PPMS) showed less improvement than did those with 
relapsing-remitting MS (RRMS) on the psychological scale at 1 month, and 
venoplasty treatment of more vein sites versus fewer vein sites showed greater 
improvement on the physical scale at both 1 and 6 months. Fifteen patients 
(6.3%) reported recurrent symptoms after clinical improvement and were treated 
again. There was one serious adverse event, a deep venous thrombosis at the 
catheter insertion site, which resolved with treatment.
CONCLUSIONS: Endovascular treatment of CCSVI in patients with MS appears to be a 
safe procedure resulting in significant clinical improvement.