CCSVI: possono i sintomi dell'insufficienza venosa cronica cerebrospinale essere migliorati dall'angioplastica venosa?
Lo scopo dello studio è stato quello di raccogliere i risultati di 366 pazienti cronici affetti da insufficienza venosa cronica cerebrospinale (CCSVI) che sono stati regolarmente controllati dopo aver effettuato l'angioplastica venosa dopo la diagnosi per CCSVI. Le procedure sono state tutte eseguite con la stessa apparecchiatura e nello stesso centro I pazienti sono stati divisi in tre gruppi in base alla gravità di sclerosi multipla (SM): 264 recidivante-remittente (RR) (72%): 179 femmine (67.8%) e 85 maschi (32,2%); 62 secondaria progressiva (SP) (17%): 37 femmine (59,7%) e 25 maschi (40,3%) ; 40 primaria progressiva (PP) (11%): 22 (55%) di sesso femminile e 18 (45%) maschi. Una base di dati ha rivelato undici disturbi e sintomi più frequenti, insieme alla capacità di lavoro, ed è stato mantenuto un up-to-date ad ogni controllo al fine di creare un rapido questionario di valutazione sui diversi sintomi di CCSVI in 4 anni di follow-up. I sintomi erano: diplopia, stanchezza, mal di testa, intorpidimento degli arti superiori / mobilità, intorpidimento degli arti inferiori / mobilità, sensibilità termica, controllo della vescica, coordinazione dell'equilibrio, qualità del sonno, vertigini, concentrazione mentale. I risultati, come segue, sembrano essere notevolmente buoni nel gruppo RR, anche il più grande. Diplopia migliorata in 262/264 pazienti (99,2%) (p <0,0001); fatica 260/264 (98,5%) (p <0,0001); cefalea a 205/208 (98,6%) (p <0,0001); coordinazione equilibrio in 23/26 (88,5%) (p <0,0001); qualità del sonno in 55/59 (93,2%) (p <0,0001); vertigini a 30/33 (90,9%) (p <0,0001); concentrazione mentale in 142/144 (98,6%) (p <0,0001). Altri risultati hanno riguardato: intorpidimento degli arti superiori e la mobilità a 20/24 (83,3%) (p = 0,0002); intorpidimento degli arti inferiori e la mobilità 13/15 (86,7%) (p = 0,0087); sensibilità termica 3/4 (75%) (p: n.s.); controllo della vescica 2/3 (66,6%) (p: n.s.). Al contrario, nei casi progressivi, i risultati sono molto diversi in cui, tuttavia, alcune considerazioni utili sono stati raccolte e statisticamente significative. Inoltre, l'angioplastica venosa sembra essere sicura, gli effetti collaterali sono stati osservati solo in sette pazienti (0,19%) dove vi era una trombosi monolaterale giugulare, ma ancora sono stati regolarmente controllati e, soprattutto, non hanno sofferto un peggioramento della malattia. Infine, i risultati schiaccianti della PTA del gruppo RR per dire che i criteri corretti dovrebbero esserci il più presto possibile.
The aim of the study was to collect results from 366 chronic cerebrospinal venous insufficiency (CCSVI) affected patients that were regularly Duplex controlled after having received vein angioplasty following diagnosis for CCSVI. The procedures were all performed in the same Centre and same equipment. The patients were divided into three groups according to the attributed severity of the associated multiple sclerosis (MS): 264 Relapse-Remitting (RR)(72%): 179 females (67.8%) and 85 (32.2%) males; 62 Secondary Progressive (SP) (17%): 37 (59.7%) females and 25 (40.3%) males; 40 Primary Progressive (PP) (11%): 22 (55%) females and 18 (45%) males. A data base revealed eleven most frequent disturbs and symptoms, together with working capacities, and was kept up-to-date at every Duplex control aiming to establish a novel rapid CCSVI symptoms questionnaire assessment in 4 years follow up. The symptoms were: diplopia, fatigue, headache, upper limb numbness/mobility, lower limb numbness/mobility, thermic sensibility, bladder control, balance coordination, quality of sleep, vertigo, mind concentration. Results, as follows, appear to be significantly good in the RR group, also the biggest one. Diplopia improved in 262/264 patients (99.2%) (p<0.0001); fatigue in 260/264 (98.5%) (p<0.0001); headache in 205/208 (98.6%) (p<0.0001); balance coordination in 23/26 (88.5%) (p<0.0001); quality of sleep in 55/59 (93.2%) (p<0.0001); vertigo in 30/33 (90.9%) (p<0.0001); mind concentration in 142/144 (98.6%) (p<0.0001). Other results regarded: upper limb numbness and mobility in 20/24 (83.3%) (p=0.0002); lower limb numbness and mobility 13/15 (86,7%) (p=0.0087); thermic sensibility 3/4 (75%) (p: n.s.); bladder control 2/3 (66.6%) (p: n.s.). In contrast in the progressive cases results are quite different where, nevertheless, some useful considerations were collected and statistically significant too. In addition, venous angioplasty appears to be safe, side effects were observed only in seven patients (0.19%) that grew a monolateral Jugular thrombosis but still were regularly controlled and above all didn’t suffer worsening of the disease. Finally, the overwhelming PTA results in the RR group lead to say that the correct criteria should be the sooner the better.
The aim of the study was to collect results from 366 chronic cerebrospinal venous insufficiency (CCSVI) affected patients that were regularly Duplex controlled after having received vein angioplasty following diagnosis for CCSVI. The procedures were all performed in the same Centre and same equipment. The patients were divided into three groups according to the attributed severity of the associated multiple sclerosis (MS): 264 Relapse-Remitting (RR)(72%): 179 females (67.8%) and 85 (32.2%) males; 62 Secondary Progressive (SP) (17%): 37 (59.7%) females and 25 (40.3%) males; 40 Primary Progressive (PP) (11%): 22 (55%) females and 18 (45%) males. A data base revealed eleven most frequent disturbs and symptoms, together with working capacities, and was kept up-to-date at every Duplex control aiming to establish a novel rapid CCSVI symptoms questionnaire assessment in 4 years follow up. The symptoms were: diplopia, fatigue, headache, upper limb numbness/mobility, lower limb numbness/mobility, thermic sensibility, bladder control, balance coordination, quality of sleep, vertigo, mind concentration. Results, as follows, appear to be significantly good in the RR group, also the biggest one. Diplopia improved in 262/264 patients (99.2%) (p<0.0001); fatigue in 260/264 (98.5%) (p<0.0001); headache in 205/208 (98.6%) (p<0.0001); balance coordination in 23/26 (88.5%) (p<0.0001); quality of sleep in 55/59 (93.2%) (p<0.0001); vertigo in 30/33 (90.9%) (p<0.0001); mind concentration in 142/144 (98.6%) (p<0.0001). Other results regarded: upper limb numbness and mobility in 20/24 (83.3%) (p=0.0002); lower limb numbness and mobility 13/15 (86,7%) (p=0.0087); thermic sensibility 3/4 (75%) (p: n.s.); bladder control 2/3 (66.6%) (p: n.s.). In contrast in the progressive cases results are quite different where, nevertheless, some useful considerations were collected and statistically significant too. In addition, venous angioplasty appears to be safe, side effects were observed only in seven patients (0.19%) that grew a monolateral Jugular thrombosis but still were regularly controlled and above all didn’t suffer worsening of the disease. Finally, the overwhelming PTA results in the RR group lead to say that the correct criteria should be the sooner the better.
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