# CCSVI and Liberation Therapy for Multiple Sclerosis

Sham-controlled venoplasty has not demonstrated MS disability benefit; a positive MRI reanalysis remains a bounded lead, while objective vascular and device complications establish that treatment can cause harm.

Preregistered primary-SC3 aggregation returns Β: meaningful flow/MRI evidence is retained, but clinical benefit is not demonstrated and sham improvement supplies a more parsimonious explanation for uncontrolled subjective response. A single Step11 downgrade from the Γ mechanistic/proxy starting point is explicit. Weakest-link aggregation would return Α because SC1 universal reproducibility/specificity fails; procedural injury Ε is separate and cannot determine a benefit score.

Trial disease stages, low-EDSS diagnostic cohorts, pediatric/CIS timing, balloon versus stent, anatomical subtype, collateral physiology and operator experience are explicit boundaries. Favorable anatomy is a post hoc finding to prospectively test, not a retrospectively adopted responder-only scope. No blanket rejection of all vascular contributions to MS follows.