NICE encourages research for percutaneous venoplasty to relieve multiple sclerosis symptoms


The UK’s National Institute for Health and Clinical Excellence (NICE) is encouraging further research into percutaneous venoplasty a procedure which could relieve symptoms for some people with multiple sclerosis. The draft guidance was published on 24 August 2011.

Percutaneous venoplasty aims to improve blood flow from the brain by using a small inflatable balloon or stent to widen narrowed veins in the neck. It has been suggested that there could be a link between narrowed veins ‰Û¥ condition named chronic cerebrospinal venous insufficiency (CCSVI) ‰Û¥ and the progression of multiple sclerosis.

Following a public meeting in July, NICE’s independent committee is proposing in its draft guidance that the procedure should be used in the context of research only, so that further evidence on its safety and clinical efficacy can be developed; for example to explore its impact on quality of life.

Bruce Campbell, chair of the independent committee that develops NICE’s interventional procedures guidance said, “Multiple sclerosis can be a distressing and disabling condition with a lack of effective treatments. This means that it is really important to find out whether percutaneous venoplasty is clinically effective and safe for use in the National Health Service (NHS). Based on the existing evidence, we believe that clinicians should only consider offering percutaneous venoplasty as a treatment option for people with multiple sclerosis who fit the diagnostic criteria for CCSVI, as part of structured clinical trials.

“In particular, we would welcome controlled research comparing percutaneous venoplasty against ‘sham venoplasty’, in the same way that drug treatments are compared to a placebo. This is so that we can learn more about whether venoplasty works and for how long. Further research could also improve the understanding of the relationship between multiple sclerosis and CCSVI, as this is very unclear at present”.

“We encourage anyone with a special interest or experience of the procedure to comment on our committee’s provisional advice for the NHS during this consultation period. This is so that all views can be considered appropriately, and so that NICE’s final guidance can be of the greatest benefit for the future treatment of patients with multiple sclerosis who have CCSVI and the wider NHS.”

NICE will publish its final guidance for the NHS in December, after its committee has reviewed the comments received and held a further public meeting in October.

The final guidance will advise the NHS on what the latest evidence and specialist opinion say about the safety and efficacy of percutaneous venoplasty, and what doctors should do if they wish to consider it as a treatment option for their patients with multiple sclerosis who have CCSVI.