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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.

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