Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Feb;5(1):40-6.
doi: 10.1111/j.1747-4949.2009.00405.x.

Design of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST)

A J Sheffet  1 , G Roubin, G Howard, V Howard, W Moore, J F Meschia, R W Hobson 2nd, T G Brott
Affiliations
Randomized Controlled Trial

Design of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST)

A J Sheffet et al. Int J Stroke. 2010 Feb.

Abstract

Rationale: Carotid endarterectomy (CEA) and medical therapy were shown superior to medical therapy alone for symptomatic (> or =50%) and asymptomatic (> or =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 (> or =50%) or asymptomatic (> or =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.

PubMed Disclaimer

References

    1. Goldstein LB, Adams R, Alberts MJ, et al. Primary Prevention of Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Stroke. 2006;37(6):1583–633. - PubMed
    1. Adams RJ, Albers G, Alberts MJ, et al. Update to the AHA/ASA Recommendations for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke. 2008;39(5):1647–52. - PMC - PubMed
    1. Furlan AJ. Carotid-Artery Stenting -- Case Open or Closed? N Engl J Med. 2006;355(16):1726–9. - PubMed
    1. Bonvini RF, Righini M, Hamon M, et al. Endarterectomy versus Stenting for Carotid Stenosis. N Engl J Med. 2007;356(3):305–7. - PubMed
    1. Barrett KM, Brott TG. Carotid Artery Stenting Versus Carotid Endarterectomy: Current Status. Neurosurgery Clinics of North America. 2008;19(3):447–58. - PubMed

Publication types