Crest-e trial

Cardiovasc Surg. Epub Jan Circ Cardiovasc Interv. Epub Aug 5. Duration of asymptomatic status and outcomes following carotid endarterectomy and carotid artery stenting in the Carotid Revascularization Endarterectomy vs Stenting Trial.

Epub Jan 8. Circ Cardiovasc Qual Outcomes. Epub Dec 4. Carotid angiographic characteristics in the CREST trial were major contributors to periprocedural stroke and death differences between carotid artery stenting and carotid endarterectomy. Epub Oct Epub Sep 8. Characteristics of participants consenting versus declining follow-up for up to 10 years in a randomized clinical trial.

Clin Trials. Epub Jun Effect of patching on reducing restenosis in the carotid revascularization endarterectomy versus stenting trial. J Am Heart Assoc. Complication rates and center enrollment volume in the carotid revascularization endarterectomy versus stenting trial. Epub Sep Picking the good apples: statistics versus good judgment in choosing stent operators for a multicenter clinical trial. Financial management of a large multisite randomized clinical trial.

Epub Mar Agreement between site-reported and ultrasound core laboratory results for duplex ultrasound velocity measurements in the Carotid Revascularization Endarterectomy versus Stenting Trial. Carotid artery stenting: a clinical update. Curr Opin Cardiol. Age and outcomes after carotid stenting and endarterectomy: the carotid revascularization endarterectomy versus stenting trial.

Epub Oct 6. J Am Coll Cardiol. Stenting versus aggressive medical therapy for intracranial arterial stenosis. Epub Sep 7. Epub May 5. National Library of Medicine U. National Institutes of Health U. Department of Health and Human Services.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Not Applicable. Study Type :. Interventional Clinical Trial. Actual Enrollment :. Study Start Date :. Actual Primary Completion Date :. Actual Study Completion Date :. Active Comparator: Carotid Artery Endarterectomy CEA Carotid endarterectomy is surgery to remove plaque buildup that causes narrowing stenosis in the carotid artery.

Dignity Health dba St. The patients were very well matched in terms of demographics other than a slightly higher preponderance of patients with dyslipidemia in the CEA group The overwhelming majority of CAS procedures were performed with embolic protection There was a surprisingly high rate There was no difference in the primary study endpoint of any periprocedural stroke, MI, death, or postprocedural ipsilateral stroke within 30 days CAS 5.

For the individual endpoint of periprocedural death CAS 0. There was no statistical difference in major ipsilateral stroke incidence in the perioperative period CAS 0. After the periprocedural period, the incidence of ipsilateral stroke was similar CEA 2. There was no difference in the primary endpoint during the perioperative period among symptomatic patients CAS 6.

The crossover point for age was at approximately 70 years, with greater efficacy with CAS in younger patients and greater efficacy with CEA for older patients. The risk of cranial nerve injury was significantly higher in the CEA group 0. While there was a difference in the risk of perioperative stroke with an increased risk in the endovascular group, most of these strokes were minor.

Conversely, there was a higher risk of MI in the surgical group. Beyond the perioperative period, the efficacy of the procedures in stroke prevention is equivalent, however. These results contradict the results of the recent randomized European trials that have compared CAS and CEA, all of which showed inferiority or failed to show superiority. Unlike the results of previous CEA trials, there was no effect of sex on procedural effectiveness, and there was not any differential benefit based on symptomatic status.

There was a significant benefit to CAS in younger patients and vice versa. There are several issues that have not yet been addressed by the published results, including the comparative long-term patency or need for repeat revascularization with each procedure has yet to be determined. Moreover, newer embolic protection devices and stents have become available and could be associated with lower stroke rates, thus indicating the potential to further improve on CREST's CAS outcomes.

She has disclosed that she holds no financial interest in any product or manufacturer mentioned herein. He has disclosed that he holds no financial interest in any product or manufacturer mentioned herein.

Abou-Chebl may be reached at ; a. By William A. Previous Article. Next Article right-arrow Created with Sketch. In-depth analyses of CREST and other major carotid revascularization trials, and how their results will affect practices around the world.

The study was stopped early as results from the first planned interim analysis revealed that further treatment and followup in the trial would not show a beneficial effect of creatine in delaying functional neurologic decline. In the study, participants were randomly assigned to receive placebo and were assigned to receive creatine. For the latter, dosage began at 10 grams g of creatine daily and was increased up to a target daily dose of 40 g.