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A report on the EC/IC bypass study.

M Hopkins, B M Valberg, L M Robinson

    The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses
    |August 1, 1986
    PubMed
    Summary
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    Extracranial to intracranial (EC/IC) bypass surgery is a treatment for blocked arteries. The International Cooperative Study of EC/IC Arterial Anastomosis found it did not significantly reduce stroke risk in patients with recent ischemic symptoms.

    Area of Science:

    • Neurosurgery
    • Vascular Surgery
    • Neurology

    Background:

    • Extracranial to intracranial (EC/IC) arterial anastomosis, or bypass surgery, emerged in 1967.
    • It became a standard treatment for intracranial atherosclerotic lesions causing stenosis or occlusion.
    • The procedure aims to restore blood flow to the brain via superficial arteries.

    Purpose of the Study:

    • To evaluate the efficacy of EC/IC bypass surgery in preventing stroke and related death.
    • To assess the surgical procedure's role in stroke prevention for patients with specific neurological symptoms.
    • To provide data on the outcomes of EC/IC bypass surgery in a large patient cohort.

    Main Methods:

    • An international, multicenter, randomized clinical trial was conducted.

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  • 1,377 patients with recent hemispheric and/or retinal ischemic symptoms were enrolled.
  • The study compared EC/IC bypass surgery against medical management.

    • Main Results:

    • The International Cooperative Study of Extracranial/Intracranial Arterial Anastomosis analyzed data from 1985.
    • The trial did not demonstrate a significant reduction in stroke or stroke-related death rates for patients undergoing EC/IC bypass.
    • Results indicated no significant benefit of EC/IC bypass over medical therapy for the studied patient population.

    Conclusions:

    • EC/IC bypass surgery was not found to be more effective than medical treatment for stroke prevention in patients with recent ischemic symptoms.
    • The study provided critical evidence influencing the surgical management of cerebrovascular disease.
    • Further research may be needed to identify specific patient subgroups who could benefit from EC/IC bypass.