Design of the carotid revascularization endarterectomy vs. stenting trial (CREST)

A. J. Sheffet, G. Roubin, G. Howard, V. Howard, W. Moore, J. F. Meschia, R. W. Hobson, T. G. Brott

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74 Scopus citations

Abstract

Rationale: Carotid endarterectomy (CEA) and medical therapy were shown superior to medical therapy alone for symptomatic (≥50%) and asymptomatic (≥60%) stenosis. Carotid angioplasty stenting (CAS) offers a less invasive alternative. Establishing safety, efficacy, and durability of CAS requires rigorous comparison with CEA in symptomatic and asymptomatic patients. Aims: The objective is to compare the efficacy of CAS versus CEA in patients with symptomatic (≥50%) or asymptomatic (≥60%) extracranial carotid stenosis. Design: The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) is a prospective, randomized, parallel, two-arm, multi-center trial with blinded endpoint adjudication. Primary endpoints are analyzed using standard time-to-event statistical modeling with adjustment for major baseline covariates. Primary analysis is on an intent-to-treat basis. Study Outcomes: The primary outcome is the occurrence of any stroke, myocardial infarction, or death during a 30-day peri-procedural period, and ipsilateral stroke during follow-up of up to four years. Secondary outcomes include restenosis and health-related quality of life.

Original languageEnglish (US)
Pages (from-to)40-46
Number of pages7
JournalInternational Journal of Stroke
Volume5
Issue number1
DOIs
StatePublished - Feb 1 2010

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Keywords

  • Carotid endarterectomy
  • Carotid stenosis
  • Carotid stenting
  • Randomized trial
  • Stroke prevention

ASJC Scopus subject areas

  • Neurology

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