Last updated on June 2019

Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial


Brief description of study

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.

Detailed Study 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.

Clinical Study Identifier: NCT02089217

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Lankenau Medical Center

Wynnewood, PA United States
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Hennepin County Medical Center

Minneapolis, MN United States
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Winchester Medical Center

Winchester, VA United States
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St. Mary's Medical Center

Grand Junction, CO United States
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Mayo Clinic

Jacksonville, FL United States
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Doylestown Hospital

Doylestown, PA United States
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The Miriam Hospital

Providence, RI United States
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Baptist Memorial Hospital

Memphis, TN United States
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Northwestern University

Evanston, IL United States
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University of Iowa

Iowa City, IA United States
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Morton Plant Hospital

Clearwater, FL United States
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UPMC Hamot

Erie, PA United States
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University of Wisconsin

Madison, WI United States
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Kaiser Permanente

San Diego, CA United States
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Lyerly Neurosurgery

Jacksonville, FL United States
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Hartford Hospital

Hartford, CT United States
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Prairie Heart/St. John's Hospital

Springfield, IL United States
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Henry Ford Health System

Detroit, MI United States
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William Beaumont Hospital

Royal Oak, MI United States
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University of Virginia

Charlottesville, VA United States
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Franciscan St. Francis Health

Indianapolis, IN United States
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Baptist Health Lexington

Lexington, KY United States
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Emory University

Atlanta, GA United States
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San Francisco VA Medical Center

San Francisco, CA United States
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St. Joseph's Medical Center

Stockton, CA United States
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St. Francis Hospital

Roslyn, NY United States
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Swedish Medical Center

Seattle, WA United States
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Houston Methodist Hospital

Houston, TX United States
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VA Ann Arbor Healthcare System

Ann Arbor, MI United States
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St. Cloud Hospital

Saint Cloud, MN United States
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North Central Heart Institute

Sioux Falls, SD United States
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Mayo Clinic Arizona

Phoenix, AZ United States
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Wellmont CVA Heart Institute

Kingsport, TN United States
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Cedars-Sinai Medical Center

Los Angeles, CA United States
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Trinity Health/ Michigan Heart

Ypsilanti, MI United States
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University of Virginia Health System

Charlottesville, VA United States
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Novant Health/Forsyth Medical Center

Winston-Salem, NC United States
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University of Maryland VA

Baltimore, MD United States
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Brookwood Medical Center

Birmingham, AL United States
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Kaiser Permanente Los Angeles

Los Angeles, CA United States
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Yale New Haven Hospital

New Haven, CT United States
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Southern Illinois Healthcare

Carbondale, IL United States
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The Heart Group, PC

Newburgh, IN United States
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Ochsner Health System

New Orleans, LA United States
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Maine Medical Center

Portland, ME United States
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University of Minnesota

Minneapolis, MN United States
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Mayo Clinic Rochester

Rochester, MN United States
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Mercy Hospital

Saint Louis, MO United States
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SUNY Buffalo

Buffalo, NY United States
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Ohio State Medical Center

Columbia, OH United States
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VA Pittsburgh Healthcare

Pittsburgh, PA United States
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Inova Fairfax Health Care

Falls Church, VA United States
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Gundersen Clinic, Ltd

La Crosse, WI United States
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University of Louisville

Louisville, KY United States
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Tulane University

New Orleans, LA United States
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Mercy Medical Research Institute

Springfield, MO United States
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Valley Baptist Medical Center

Harlingen, TX United States
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Recruitment Status: Open


Brief Description Eligibility Contact Research Team


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