Final guidance from the UK’s National Institute for Health and Clinical Excellence (NICE), released on 28 March, encourages further research into percutaneous venoplasty, a procedure which is claimed to relieve symptoms for some people with multiple sclerosis.
The procedure aims to improve blood flow from the brain by using a small inflatable balloon to widen narrowed veins in the neck which carry oxygen-depleted blood. It has been suggested that there could be a link between narrowed veins (called chronic cerebrospinal venous insufficiency, or CCSVI) and the progression of multiple sclerosis.
NICE’s guidance advises the procedure should be only performed on these patients in the context of clinical research. This is so that more evidence on its safety and efficacy can be developed; for example to explore the impact that the procedure could have on quality of life in the long term.
Professor 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 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”
“This is so that we can learn more about whether venoplasty works and if so for how long. Further research could also investigate the relationship between MS and CCSVI, as this is very unclear at present”.
NICE’s guidance outlines what NHS healthcare professionals should do if they wish to consider percutaneous venoplasty as a treatment option, based on its safety and efficacy only. Cost is not considered in this type of guidance.