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

Research output: Contribution to journalArticlepeer-review

78 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 2010

Keywords

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

ASJC Scopus subject areas

  • Neurology

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