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.
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
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
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.
If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.
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