Extracranial–Intracranial Arterial Bypass

To the Editor: In a recent Journal article, "Failure of Extracranial– Intracranial Arterial Bypass to Reduce the Risk of Ischemic Stroke," the results of a randomized, international, multicenter study were reported (November 7 issue). 1 The report, which was highlighted in an editorial in the same issue, 2 concluded that there was no indication for the procedure in the group as a whole or in any of the subgroups that the investigators identified. It appears to us that the procedures and results of the bypass study are not sufficient to demonstrate whether there exists a small subgroup (perhaps as large as 10 . . .