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

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

Research output: Contribution to journalArticle

73 Citations (Scopus)

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 2010

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Carotid Endarterectomy
Angioplasty
Stroke
Carotid Stenosis
Pathologic Constriction
Myocardial Infarction
Quality of Life
Outcome Assessment (Health Care)
Safety
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Neurology

Cite this

Design of the carotid revascularization endarterectomy vs. stenting trial (CREST). / Sheffet, A. J.; Roubin, G.; Howard, G.; Howard, V.; Moore, W.; Meschia, James F; Hobson, R. W.; Brott, Thomas G.

In: International Journal of Stroke, Vol. 5, No. 1, 02.2010, p. 40-46.

Research output: Contribution to journalArticle

Sheffet, A. J. ; Roubin, G. ; Howard, G. ; Howard, V. ; Moore, W. ; Meschia, James F ; Hobson, R. W. ; Brott, Thomas G. / Design of the carotid revascularization endarterectomy vs. stenting trial (CREST). In: International Journal of Stroke. 2010 ; Vol. 5, No. 1. pp. 40-46.
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