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New Trial Finds Using Balloons to Increase Blood Flow from Brain Fails to Help MS Patients

December 14, 2017

A clinical trial conducted in Italy used balloons to enlarge veins in order to allow more blood to flow out of the brain and spinal cord. Unfortunately, the trial failed to aid multiple sclerosis (MS) patients. The procedure, venous percutaneous transluminal angioplasty, was safe, although it did not improve functioning or reduce brain lesions.

The study was conducted using relapsing-remitting multiple sclerosis patients (RRMS) that had a condition called chronic cerebrospinal venous insufficiency. Those with the condition typically have narrowed veins which limit blood flow from the brain and spinal cord back to the heart. The title of the study is “Efficacy and Safety of Extracranial Vein Angioplasty in Multiple Sclerosis a Randomized Clinical Trial.”

Angioplasty is done by inserting a catheter with a balloon on its end into a blood vessel, then the balloon is inflated to enlarge the vein and restore a normalized blood flow.

The trial involved 115 patients between the ages of 18 and 65 with RRMS. The trial was conducted at six MS centers and aimed to see if angioplasty would increase blood flow from patients’ brains and spinal cords. 76 of the 115 patients went through the angioplasty procedure while the remaining 39 acted as a control group, where doctors still inserted a catheter into their blood vessels but no balloon.

The researchers followed up with the two groups for 12 months, performing MRI scans on them at a six-month mark and a 12-month mark to check for new or enlarged brain lesions.

While 54 percent of the angioplasty group were able to have restored blood flow, it failed to improve their functioning. The two groups had similarities in their measurements of balance, dexterity, vision and ability to walk. There were no differences in the amount of urine left in patients’ bladder after they urinated.

However, in the control group, the percentage of angioplasty patients who failed to develop new brain lesions was higher, though the difference was small and researchers have called for more studies on the matter.

The researchers concluded that angioplasty “did not increase the proportion of patients with RRMS who improved on the functional composite measure” in comparison to the other procedure over the 12-month follow-up. It also did not reduce the appearance of new combined brain lesions on MRI at 0 to 12 months. The annualized relapse rate was also similar between the two groups.

Researchers also concluded that the procedure proved to be safe, yet largely ineffective, and cannot be recommended to MS patients.