{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:34:22Z","timestamp":1792409662351,"version":"4.4.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Although no benefits of extracranial-intracranial (EC-IC) bypass surgery in preventing secondary stroke have been identified previously, the outcomes of initial symptomatic ischemic stroke and stenosis and\/or occlusion among the Asian population in patients with or without bypass intervention have yet to be discussed. The authors aimed to evaluate the subsequent risk of secondary vascular disease and cardiac events in patients with and without a history of this intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This retrospective nationwide population-based Taiwanese registry study included 205,991 patients with initial symptomatic ischemic stroke and stenosis and\/or occlusion, with imaging data obtained between 2001 and 2010. Patients who underwent EC-IC bypass (bypass group) were compared with those who had not undergone EC-IC bypass, carotid artery stenting, or carotid artery endarterectomy (nonbypass group). Patients with any previous diagnosis of ischemic or hemorrhagic stroke, moyamoya disease, cancer, or trauma were all excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The risk of subsequent ischemic stroke events decreased by 41% in the bypass group (adjusted hazard ratio [HR] 0.59, 95% CI 0.46\u20130.76, p &lt; 0.001) compared with the nonbypass group. The risk of subsequent hemorrhagic stroke events increased in the bypass group (adjusted HR 2.47, 95% CI 1.67\u20133.64, p &lt; 0.001) compared with the nonbypass group.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Bypass surgery does play an important role in revascularization of the ischemic brain, while also increasing the risk of hemorrhage in the early postoperative period. This study highlights the fact that the high risk of bypass surgery obscures the true benefit of revascularization of the ischemic brain and also emphasizes the importance of developing improved surgical technique to treat these high-risk patients.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.12.jns172178","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T13:59:47Z","timestamp":1527861587000},"page":"1906-1913","source":"Crossref","is-referenced-by-count":15,"title":["Risk of subsequent stroke, with or without extracranial-intracranial bypass surgery: a nationwide, retrospective, population-based study"],"prefix":"10.3171","volume":"130","author":[{"given":"XianXiu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Public Health, China Medical University;"},{"name":"Stroke Center, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Li","family":"Lin","sequence":"additional","affiliation":[{"name":"College of Medicine, China Medical University;"},{"name":"Management Office for Health Data, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Chih","family":"Su","sequence":"additional","affiliation":[{"name":"College of Medicine, China Medical University;"},{"name":"Management Office for Health Data, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Wei","family":"Lai","sequence":"additional","affiliation":[{"name":"College of Medicine, China Medical University;"},{"name":"Department of Family Medicine, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Tai","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Tien","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Hemato-oncology, Children\u2019s Hospital, China Medical University;"},{"name":"Department of Biotechnology, Asia University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Di","family":"Chiu","sequence":"additional","affiliation":[{"name":"Stroke Center, China Medical University Hospital;"},{"name":"Department of Neurosurgery, China Medical University Hospital;"},{"name":"Graduate Institute of Basic Medical Science, China Medical University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shwn-Huey","family":"Shieh","sequence":"additional","affiliation":[{"name":"Department of Health Services Administration, China Medical University, Taichung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chung","family":"Chen","sequence":"additional","affiliation":[{"name":"Stroke Center, China Medical University Hospital;"},{"name":"College of Medicine, China Medical University;"},{"name":"Department of Neurosurgery, China Medical University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg Sci","first-page":"107","article-title":"Cerebral revascularization: extracranial-intracranial bypass","volume":"55","author":"Amin-Hanjani S","year":"2011","unstructured":"Amin-Hanjani S: Cerebral revascularization: extracranial-intracranial bypass. 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