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Results of the Extracranial-lntracranial Bypass Study

R. Brian Haynes, MD, PhD; Jayanti Mukherjee, PhD; David L. Sackett, MD, MSc; D. Wayne Taylor, MA; Henry J. M. Barnett, MD; Sydney J. Peerless, MD

JAMA. 1987;257(15):2043-2046.

Abstract
To determine the value of extracranial-intracranial arterial anastomosis (EC/IC bypass), we randomly allocated 1377 patients with symptomatic atherosclerosis of the internal carotid or middle cerebral arteries to medical care alone or to EC/IC bypass with continuing medical care. As previously reported, surgery did not reduce—or significantly increase—the risk of stroke. Functional status data collected during the trial provide new information. Six weeks following entry, surgical patients showed greater dysfunction in the following activities: fluency of speech, getting in and out of bed, sitting down and standing up, toileting, cutting food and pouring beverages, and dressing and undressing. At 4.5 months, surgical patients still exhibited greater dysfunction in toileting, with nonsignificant trends in several other activities. From six months onward, there were no significant differences between the groups. Thus, EC/IC bypass results in transient worsening of functional status beyond the immediate perioperative period.

(JAMA 1987;257:2043-2046)

Author Affiliations
From the Departments of Clinical Epidemiology and Biostatistics (Drs Haynes, Mukherjee, and Sackett and Mr Taylor) and Medicine (Drs Haynes and Sackett), McMaster University, Hamilton, Ontario; and the Department of Clinical Neurosciences, University of Western Ontario, London (Drs Barnett and Peerless).

Footnotes
Reprint requests to the Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr Haynes).

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