Are the Results of the Extracranial–Intracranial Bypass Trial Generalizable?

The dramatic results of the extracranial–intracranial (EC–IC) bypass trial have stimulated the vigorous discussion and debate that are essential to the pursuit of truth and the advancement of useful clinical knowledge.^{1 2 3} We therefore thank Dr. Sundt for his spirited critique.⁴ We also thank the editors of the Journal for the opportunity to respond to Dr. Sundt and to emphasize again the usefulness of randomized clinical trials in determining whether an innovative therapy is of value. We begin by observing that Dr. Sundt has no quarrel with the evaluation, randomization, 100 percent follow-up, analysis, and interpretation of results among the 1377…