6/28/23, 12:22 AM CREST Pathway Feedback Search Clinical Topics Home Studies CREST CREST Disease Disease Carotid artery stenosis Transient ischemic attack Trial question What is the role of carotid artery stenting in patients with symptomatic or asymptomatic stenosis? Study design Multi-center Open label RCT Population Characteristics of study participants 35.0% female N = 2502 65.0% male 2502 patients (872 female, 1630 male) Inclusion criteria: patients with symptomatic or asymptomatic carotid stenosis Key exclusion criteria: previous stroke sufficiently severe to confound the assessment of end points, chronic AF, paroxysmal AF that had occurred within the preceding 6 months or that necessitated anticoagulation therapy, myocardial infarction within the previous 30 days, or unstable angina Interventions N=1271 carotid artery stenting (RX Acculink stent and, whenever feasible, the RX Accunet embolic-protection device plus antiplatelet therapy with aspirin and clopidogrel) N=1251 carotid endarterectomy (carotid endarterectomy plus antiplatelet therapy with aspirin) Primary outcome https://web.pathway.md/studies/recTBk7S0sZeLnglk 1/2 6/28/23, 12:22 AM CREST Pathway Stroke, myocardial infarction, or death from any cause during periprocedural period, or any ipsilateral stroke at 4 years 7.2 % 7.2 6.8 5.4 % 3.6 % 1.8 % No significant difference 0.0 % Carotid artery stenting Carotid endarterectomy No significant difference in stroke, myocardial infarction, or death from any cause during the periprocedural period, or any ipsilateral stroke at 4 years (7.2% vs. 6.8%; HR 1.11, 95% CI 0.81 to 1.51) Secondary outcomes Significant increase in stroke or death at 4 years (6.4% vs. 4.7%; HR 1.5, 95% CI 1.05 to 2.15) Significant decrease in myocardial infarction (1.1% vs. 2.3%; HR 0.5, 95% CI 0.26 to 0.94) Conclusion In patients with symptomatic or asymptomatic carotid stenosis, carotid artery stenting was not superior to carotid endarterectomy with respect to stroke, myocardial infarction, or death from any cause during the periprocedural period, or any ipsilateral stroke at 4 years. Reference Brott TG, Hobson RW nd, Howard G et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010 Jul 1;363(1):11-23. Open reference URL https://web.pathway.md/studies/recTBk7S0sZeLnglk 2/2