Is extracranial-intracranial bypass surgery effective in certain patients?

The role of surgical revascularization for patients who have ischemic disease remains controversial. Despite the previous EC-IC bypass trial that failed to demonstrate the benefit from STA-MCA bypass compared with medical therapy, however, there is mounting evidence that the procedure should be considered in selected patients. Bypass remains a mainstay of treatment in moyamoya disease and in flow replacement in the setting of planned vessel sacrifice.