An interventional and medical management trial for those diagnosed with asymptomatic high-grade carotid stenosis

Study ID: CREST-2

CREST-2: Carotid revascularization and medical management for asymptomatic carotid stenosis trial

Carotid revascularization for primary prevention of stroke (CREST-2) consists of two independent multicenter clinical trials of carotid revascularization and intensive medical management vs. medical management alone in patients with asymptomatic high-grade carotid stenosis. There are two study arms:

  • One will group patients in a 1:1 ratio to endarterectomy (surgical removal of part of the inner lining of an artery) vs. no endarterectomy.
  • The other study arm will consist of participants who will be grouped in a 1:1 ratio to carotid stenting with embolic protection vs. no stenting.

Medical management will be the same for both groups.

CREST-2 is two parallel, multi-center, randomized, observer-blinded, endpoint clinical trials. Patients will be selected for either the CEA vs. intensive medical management trial or the CAS vs. intensive medical management trial based upon eligibility criteria for CEA or CAS.

Intensive medical management will involve control of blood pressure, LDL cholesterol, cigarette smoking, and other vascular risk factors. To approximate real-world practice, enrollment of such patients will follow referral patterns at a given center. Mechanisms will be in place to ensure enrollment of approximately 1,240 patients in each of the trials.

Inclusion Snapshot

Must have been diagnosed with asymptomatic high-grade carotid stenosis

Contact Information

Lankenau Institute for Medical Research trial

Physician Investigator(s)

Study Locations