STAMCAR: A Prospective EC-IC Bypass Registry

A prospective registry evaluating the efficacy of EC-IC bypass in a subgroup of patients, specifically, patients with carotid occlusion and symptoms refractory to medical therapy and evidence for poor cerebrovascular reserve as evaluated by physiological testing (e.g. Diamox Challenge SPECT Scan). This subgroup includes: 1. Hospitalized unstable patient with crescendo or postural TIA's 2. Patients with multiple TIA's, limb-shaking TIA's, and/or cognitive decline despite medical therapy.