The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Percutaneous venoplasty for chronic cerebrospinal venous insuf´Čüciency in Multiple Sclerosis.


It is possible that there is a link between blocked veins in the head, neck and chest and progression of multiple sclerosis. This procedure aims to open blocked or narrowed veins by inflating a small balloon in the vein, allowing for better blood flow and a reduction in the symptoms of multiple sclerosis.

Coding recommendations

L31.4 Percutaneous transluminal insertion of stent into carotid artery


L35.3 Percutaneous transluminal insertion of stent into cerebral artery

A code from category L76 Endovascular placement of stent or L89 Other endovascular placement of stent should be added to specify the type and number of stents used. Please note that the .8 and .9 codes from extended categoryL89 must not be used.

Y53.- Approach to organ under image control

In addition ICD-10 code I67.2 Cerebral atherosclerosis is assigned.


Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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