Professor Zamboni said "The recently concluded Brave Dreams trial is a scientifically robust, double-blinded, placebo controlled trial. It uses objective measurements including MRI and other quality of life endpoints. He went on to say "Brave Dreams is a multicentre blinded randomised controlled study the objective of which is to determine the efficacy and safety of venous angioplasty (PTA) in patients with MS and CCSVI" The first of a series of reports (published in November 2017) dealing with the trial outcomes, highlighted the following: 1. CCSVI is a real condition in people with MS. 2. Venoplasty is safe and was able to restore normal flow in 54% of the patients but ineffective for the balance 3. There are a variety of venous malformations. There were patients with closed jugular valves, refluxing blood flow, & hypoperfusion. 4. Not all malformations can be treated with PTA alone 5. Other methods for treating CCSVI must be considered for cases where PTA is insufficient 6. Further research is important to identify which venous abnormalities best respond to PTA (now available) 7. A positive effect on MRI from 6-12 months with fewer mean number of new brain lesions in PTA compared to sham group. 8. 63% of treated patients had no new MS lesions on MRI at 12 months 9. PTA could affect the dynamic of the blood-brain-barrier. Professor Zamboni said The challenge is that simple angioplasty is not enough for about 50% of people. Membranes or immobile leaflets in the vein are suitable for treatment. Long, immobile and asymmetric leaflets, muscle entrapments compressing the vein and hypoplasia are not successfully treated with angioplasty. Muscle compression can block flow and may require open surgery to relieve intracranial pressure. Perfusion changes in the brain can be seen on PET following this procedure of several case studies. We will see additional techniques for treating veins not suitable for angioplasty including new stents designed for intracranial system. Learn more about the latest developments regarding the impact of vascular irregularities on MS progression at: http://www.msnetwork.org/expectations/brave-dreams-overview.htm Peter Sullivan and Kerri Cassidy, on behalf of Multiple Sclerosis Network of Care, Australia http://www.msnetwork.org