Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial

  • STATUS
    Recruiting
  • End date
    Dec 1, 2022
  • participants needed
    2480
  • sponsor
    Thomas G. Brott, M.D.
Updated on 2 June 2021
angiography
stenosis
stroke
transient ischemic attack
endarterectomy
ischemic attack
carotid revascularization

Summary

Carotid revascularization for primary prevention of stroke (CREST-2) is two independent multicenter, randomized controlled trials of carotid revascularization and intensive medical management versus medical management alone in patients with asymptomatic high-grade carotid stenosis. One trial will randomize patients in a 1:1 ratio to endarterectomy versus no endarterectomy and another will randomize patients in a 1:1 ratio to carotid stenting with embolic protection versus no stenting. Medical management will be uniform for all randomized treatment groups and will be centrally directed.

Description

Prevention of stroke involves managing and treating risk factors. Most strokes are caused when blood flow to a portion of the brain is blocked. One place this often happens is in the carotid artery. This blockage is called atherosclerosis or hardening of the arteries.

The purpose of this trial is to determine the best way to prevent strokes in people who have a high amount of blockage of their carotid artery but no stroke symptoms related to that blockage. Each eligible participant will be evaluated to determine which procedure(s) is best for him/her. All participants will receive intensive medical treatment. In addition, participants will be randomized to receive the selected procedure or not.

The trial will be conducted in the United States and Canada by physicians carefully selected on their ability to perform the procedures at low risk. Another key component of the trial is that important stroke risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, physical activity, and diet will be managed intensively. Participants will remain in the study for 4 years.

Details
Condition Carotid Artery Stenosis, Arterial Occlusive Disease, CAROTID ARTERY DISEASE, Occlusions
Treatment Carotid endarterectomy (CEA), Carotid Stenting (CAS), Intensive Medical Management - no CEA, Intensive Medical Management - no CAS
Clinical Study IdentifierNCT02089217
SponsorThomas G. Brott, M.D.
Last Modified on2 June 2021

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