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Extracranial-intracranial bypass and risk of stroke and death in patients with symptomatic artery occlusion. The CMOSS randomized clinical trial.

Ma Y, Wang T, Wang H, Amin-Hanjani S, Tong X, Wang J et al, for the CMOSS Investigators.

JAMA 2023; 330: 704-714.

Some 330 patients with transient ischaemic attack or non-disabling stroke were included. The endpoint was a composite of death within 30 days or ipsilateral stroke up to two years. The outcomes were similar after surgery and medical treatment: 8.6 versus 12.3 per cent respectively, P=0.39.

Comment: Still no definitive role for this procedure.

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