Extracranial–Intracranial Arterial Bypass and Cerebral Vascular Disease

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Abstract
IN this issue of the Journal, Barnett and his co-workers1 report the results of a remarkable piece of clinical investigation, comparing in a controlled, prospective study the neurologic effects of surgical extracranial—intracranial arterial bypass (EC—IC bypass) in 1377 randomly assigned patients with known ischemic cerebral vascular disease. Despite great technical success on the part of the surgeons in creating patency in 96 per cent of the bypassing arteries, the data demonstrate a lack of benefit of surgical treatment. With all the patients receiving equivalent appropriate medical therapy, there was no reduction in transient ischemic attacks, major strokes, or death . . .