Endovascular management of chronic cerebrospinal venous insufficiency in multiple sclerosis / Elsayed Ibrahim Younes ; Supervised Hussein Mahmoud Khairy , Mohamed Ibrahim Sharkawy , Maciej Zarebinski

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Objective: To treat venous drainage abnormality in our patients without interference with their medical treatment and to detect efficacy, safety and durability of endovascular intervention in these patient. Design: Retrospective study. Methods: Our study included 198 patients who were primary diagnosed with MS and were complaining of chronic fatigue. After accurate assessment of these patients by history taking and neurological examination, and sufficient imaging techniques were done, the diagnosis of CCSVI was overt and a decision for a liberation therapy was taken. A total number of 198 MS symptomatic patients were followed up after having endovascular therapy to their established vascular lesions using FSS scoring system compared with a baseline FSS to detect the response to fatigue improvement as well as the patency of the intervention that was held. Results: Patency percentage in our study was after one month (83.8%) , 6 months (78.3%) and 1 year (74.7%). Conclusion: To conclude our results observed in a large cohort of MS patients support the view that endovascular treatment can expose patients to severe albeit relatively rare adverse events. However the role of CCSVI in MS pathogenesis has not been confirmed. We observed an improvement in FSS and its, impact on chronic fatigue status of the patient

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