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Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their siblings, and unrelated healthy controls: a blinded, case-control study
A.L. Traboulsee, K.B. Knox, L. Machan
Journal of Vascular Surgery, Volume 59, Issue 6, June 2014, Pages 1748–1749
Multiple sclerosis affects >2 million people worldwide and is a leading cause of neurologic disability. In recent years, a vascular origin of multiple sclerosis has been proposed with the observation by Zamboni et al that multiple stenoses of the extracranial venous drainage system may be present in patients with multiple sclerosis. In the original paper, venous blockages were present in all 65 patients with multiple sclerosis examined. This study was with ultrasound and catheter venography (Zamboni P et al, J Neurol Neurosurg Psychiatry 2009;80:392-9). These combinations of blockages were not seen in healthy control participants who were studied by ultrasound imaging or in patients with other diseases who underwent catheter venography. It was therefore speculated that venous blockages have a central role in the pathogenesis of multiple sclerosis and that treatment with venoplasty may improve the course of the disease (Zamboni P et al, J Vasc Surg 2009;50:1348-58). Zamboni et al then performed an unblinded, uncontrolled interventional treatment using venoplasty in patients with multiple sclerosis and claimed improvements in disability and quality of life. However, independent research groups have not been able to reproduce the findings of Zamboni et al regarding the diagnosis of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. This has called into question the existence of the disorder and the role of venous stenoses in the etiology of multiple sclerosis.