Internal jugular thrombosis post venoplasty for CCSVI

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A single report of 33-year-old lady with MS who underwent left internal jugular venoplasty (opening of the narrowing) resulting in jugular thrombosis (clot) requiring open removal of the clot (thrombectomy) for symptom relief. This occurred without insertion of a stent and while fully anticoagulated (drugs to  thin the blood an preventing clotting). 
Conclusion: MS’ers and Clinicians should be aware that endovenous treatment ofCCSVI could cause paradoxical deterioration of cerebral venous drainage. MS’ers with complications post venoplasty are now presenting to geographically distant vascular units.
“If you have any procedures done for CCSVI please be aware of the complications; some may require urgent intervention”

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

1 comment

  • In the absence of Prof. G sharing this encouraging news, here is more information from the Buffalo angioplasty trail:

    The MRI technicians were blinded as to who was in which group. All patients were on disease modifying drugs before, during and after, for consistency in treatment. The first ITG (immediate treatment group) was operated on immediately; while the second group DTG (delayed treatment group) was treated six months later, allowing us to compare the ITG with DTG. Angioplasty for CCSVI reduced lesions, improved MS symptoms and reduced relapses, when compared to those in the delayed group on the drugs alone.

    Trail Setup:

    – There is a control group for comparison, in practice it as a randomized as possible for use in surgery

    – MRI measures are rigorous, high-standard 3-tesla, comparable and indisputable as completely blind

    – Patients were evaluated by neurologists and neuroradiologists of two centers
    – Statistical analysis was done by independent statisticians and was blinded.

    Results:

    – Both groups after the PTA had a significant improvement in the MSFC score compared to previous year, with substantial maintenance of EDSS (no disease progression)

    – In the ITG during the first 6 months there were fewer relapses. The percentage has been on an annual basis of 0.16 against 0.66 of the DTG. In fact the DTG in the first six months received only drugs. After surgery, the DTG no longer had more relapses than the ITG, confirming the protective effect of PTA on relapses.

    – ITG T2 lesion load decreased while the DTG increased. After the PTA in the DTG lesion load stabilized during the second six months.

    – Complications were zero, zero thrombosis. There was 27% restenosis.

    Conclusions:

    – CCSVI is associated with MS -as the first treatment of the condition changes the clinical parameters of the second

    – The modification of parameters in a blinded MRI is totally immune from the placebo effect, then measured the improvements are real

    – The treatment is safe in safe hands and can be beneficial.

By Prof G

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