NCT00004732

Brief Summary

The purpose of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) is to compare the relatively new procedure of stent-assisted carotid angioplasty (CAS) to the traditional and accepted surgical approach of carotid endarterectomy (CEA) for the treatment of carotid artery stenosis to prevent recurrent strokes in those patients who have had a TIA (transient ischemic attack) or a mild stroke within the past 6 months (symptomatic) and in those patients who have not had any symptoms within the past 6 months (asymptomatic).

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,502

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Dec 2000

Longer than P75 for not_applicable

Geographic Reach
2 countries

115 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 25, 2000

Completed
3 days until next milestone

First Posted

Study publicly available on registry

February 28, 2000

Completed
9 months until next milestone

Study Start

First participant enrolled

December 1, 2000

Completed
10.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2011

Completed
2.9 years until next milestone

Results Posted

Study results publicly available

December 10, 2013

Completed
3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2016

Completed
Last Updated

May 17, 2017

Status Verified

April 1, 2017

Enrollment Period

10.2 years

First QC Date

February 25, 2000

Results QC Date

September 26, 2013

Last Update Submit

April 13, 2017

Conditions

Keywords

angioplastyasymptomaticatherosclerosiscarotid endarterectomycarotid stentingCRESTCerebral Infarctiondeviceinterventionrestenosisrevascularizationstenosisstentstrokesymptomaticsurgerytransient ischemic attack

Outcome Measures

Primary Outcomes (1)

  • Any Periprocedural Stroke, Myocardial Infarction, or Death During a 30-day Peri-procedural Period, and Postprocedural Ipsilateral Stroke Thereafter, up to 4-years.

    The primary aim of CREST is to assess if the efficacy of CAS differs from that of CEA in preventing stroke, myocardial infarction and death during a 30-day peri-procedural period, or ipsilateral stroke over the follow-up period in patients with symptomatic (\>=50%) or asymptomatic (\>=60%) extracranial carotid stenosis. Four-year follow-up, proportions reflecting the absolute efficacy of carotid-artery stenting (CAS) over that of carotid endarterectomy (CEA) were based on Kaplan-Meier survival estimates at the end of the 4 years.

    30 days and 4 years

Secondary Outcomes (1)

  • Differential Efficacy of CAS and CEA in Male and Female Participants in the Primary Endpoint (Any Periprocedural Stroke, Myocardial Infarction, or Death or Postprocedural Ipsilateral Stroke).

    4 years

Study Arms (2)

Carotid Artery Endarterectomy (CEA)

ACTIVE COMPARATOR

Carotid endarterectomy is surgery to remove plaque buildup that causes narrowing (stenosis) in the carotid artery.

Procedure: Carotid Endarterectomy (CEA)

Carotid Artery Stenting (CAS)

ACTIVE COMPARATOR

Carotid artery stenting (CAS) is a procedure used to open narrowed carotid arteries. During the procedure, a small, expandable wire tube called a stent is permanently inserted into the carotid artery.

Device: Carotid Artery Stenting (CAS)

Interventions

CEA involves a neck incision and physical removal of the plaque from the inside of the carotid artery.

Carotid Artery Endarterectomy (CEA)

CAS involves insertion of a catheter or tube into an artery in the groin and then threading the catheter through the arteries of the body to the location of the plaque within the carotid artery in the neck. A stent is then placed to cover the plaque and hold the artery open. Participants randomized to this arm of the trial were treated using the RX Acculink Carotid Stent with or without the RX Accunet Embolic Protection Device.

Also known as: Angioplasty of carotid artery and stent placement.
Carotid Artery Stenting (CAS)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Symptomatic patients with recent neurological events (TIA or non-disabling stroke) with an associated carotid stenosis greater than or equal to 50% by angiography or greater than or equal to 70% by ultrasound or greater than or equal to 70% by Computed Tomography Angiography (CTA) or Magnetic Resonance Angiography (MRA) are eligible for randomization.
  • Asymptomatic patients with no recent (in the last 6 months) neurological events referable to the study with artery and carotid stenosis (patients with symptoms beyond 180 days are considered asymptomatic) greater than or equal to 60% by angiography or greater than or equal to 70% by ultrasound or greater than or equal to 80% by CTA or MRA are eligible for randomization.

You may not qualify if:

  • Conditions that: (1) interfere with the evaluation of endpoints, (2) are known to interfere with the completion of CEA or CAS, or (3) affect the likelihood of survival for the study period (4 years). Chronic atrial fibrillation and/or anti-coagulation or episodic atrial fibrillation within the last 6 months.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (115)

The Board of Trustees of the University of Alabama for the University of Alabama at Birmingham

Birmingham, Alabama, 35294, United States

Location

Dignity Health dba St. Joseph's Hospital & Medical Center

Phoenix, Arizona, 85013, United States

Location

Mayo Clinic Arizona

Scottsdale, Arizona, 85259, United States

Location

The Arizona Board of Regents for the University of Arizona

Tucson, Arizona, 85724, United States

Location

Board of Trustees of the University of Arkansas

Little Rock, Arkansas, 72701, United States

Location

USC University Hospital & LA County Hospital

Los Angeles, California, 90033, United States

Location

The Regents of the University of California

Los Angeles, California, 90095, United States

Location

Kaiser Permanente Medical Center

San Diego, California, 92120, United States

Location

Northern California Institute for Research and Education

San Francisco, California, 94121, United States

Location

Catholic Healthcare West

Stockton, California, 95204, United States

Location

Christiana Care Health Services, Inc.

Newark, Delaware, 19718, United States

Location

Morton Plant Hospital

Clearwater, Florida, 33756, United States

Location

Mayo Clinic

Jacksonville, Florida, 32224, United States

Location

Leesburg Medical Center

Leesburg, Florida, 34748, United States

Location

Miami Cardiac & Vascular Institute of Baptist Hospital of Miami, Inc.

Miami, Florida, 33187, United States

Location

Florida Hospital Neuroscience Institute, a division of Adventist Health System/Sunbelt, Inc.

Orlando, Florida, 32803, United States

Location

Orlando Regional Medical Center

Orlando, Florida, 32828, United States

Location

University of South Florida Board of Trustees

Tampa, Florida, 33606, United States

Location

Piedmont Hospital/Fuqua Heart Center

Atlanta, Georgia, 30309, United States

Location

Emory University

Atlanta, Georgia, 30322, United States

Location

St. Joseph's of Atlanta

Atlanta, Georgia, 30342, United States

Location

St. Joseph's Candler Health System

Savannah, Georgia, 31405, United States

Location

Norwestern Memorial Hospital

Chicago, Illinois, 60611, United States

Location

Alexian Brothers Specialty Group

Elk Grove Village, Illinois, 60007, United States

Location

Loyola University of Chicago

Maywood, Illinois, 60153, United States

Location

Peoria Radiology Research and Education

Peoria, Illinois, 61637, United States

Location

Prarie Cardiology-St. John's Hospital

Springfield, Illinois, 62794, United States

Location

Southern Illinois School of Medicine

Springfield, Illinois, 62794, United States

Location

Central Dupage Hospital

Winfield, Illinois, 60190, United States

Location

Lutheran Medical Group, LLC,

Fort Wayne, Indiana, 46804, United States

Location

Parkview Hospital, Inc.

Fort Wayne, Indiana, 46805, United States

Location

St. Vincent's Hospital

Indianapolis, Indiana, 46260, United States

Location

Catholic Health Initiatives /Mercy Hospital Center

Des Moines, Iowa, 50314, United States

Location

Baptist Healthcare System, Inc.

Lexington, Kentucky, 40504, United States

Location

Vascular Surgery Associates

Baton Rouge, Louisiana, 70809, United States

Location

Ochsner Foundation Hospital

New Orleans, Louisiana, 70121, United States

Location

Anne Arundel Health System Research Institute

Annapolis, Maryland, 21401, United States

Location

Johns Hopkins University

Baltimore, Maryland, 21287, United States

Location

Adventist Healthcare, Inc.

Takoma Park, Maryland, 20912, United States

Location

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Steward St. Elizabeth's Medical Center of Boston, Inc.

Boston, Massachusetts, 02135, United States

Location

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

Location

Brigham and Womens Hospital, Inc.

Boston, Massachusetts, 02215, United States

Location

Cape Cod Health Care, Inc.,

Hyannis, Massachusetts, 02601, United States

Location

University of Michigan

Ann Arbor, Michigan, 48109, United States

Location

Henry Ford Health System

Detroit, Michigan, 48202, United States

Location

St. John Hospital and Medical Center

Detroit, Michigan, 48236, United States

Location

Michigan Vascular Research Center

Flint, Michigan, 48507, United States

Location

Spectrum Health Hospital

Grand Rapids, Michigan, 49503, United States

Location

William Beaumont Hospital

Royal Oak, Michigan, 48075, United States

Location

Providence St. John Hopital

Southfield, Michigan, 48075, United States

Location

Michigan Heart & Vascular Institute/St. Joseph's Mercy Hospital

Ypsilanti, Michigan, 48197, United States

Location

North Memorial Health Care

Robbinsdale, Minnesota, 55422, United States

Location

Mayo Clinic Rochester/St. Mary's

Rochester, Minnesota, 55905, United States

Location

Mississippi Baptist Medical Center, Inc.

Jackson, Mississippi, 39202, United States

Location

Heartland Physician Services, LLC

Kansas City, Missouri, 64114, United States

Location

Mercy Hospitals East Communities

St Louis, Missouri, 63141, United States

Location

St. Patrick's Hospital International Heart Institute of MT

Missoula, Montana, 59802, United States

Location

Dartmouth College and the constituent members of DARTMOUTH HITCHCOCK MEDICAL CENTER

Lebanon, New Hampshire, 03756, United States

Location

St. Michael's Medical Center

Newark, New Jersey, 07013, United States

Location

Center for Vascular Awareness, Inc.

Albany, New York, 12208, United States

Location

Millard Fillmore SUNY Buffalo

Buffalo, New York, 14209, United States

Location

NYU School of Medicine

New York, New York, 10016, United States

Location

The Feinstein Institute for Medical Research

New York, New York, 10021, United States

Location

Weill Medical College of Cornell University

New York, New York, 10021, United States

Location

Columbia Presbyterian

New York, New York, 10032, United States

Location

St. Francis Hospital

Port Washington, New York, 11050, United States

Location

University of Rochester

Rochester, New York, 14642, United States

Location

Richmond University Medical Center

Staten Island, New York, 10310, United States

Location

Westchester Medical Center

Valhalla, New York, 10595, United States

Location

UNC at Chapel Hill

Chapel Hill, North Carolina, 27599, United States

Location

The Charlotte-Mecklenburg Hospital Authority

Charlotte, North Carolina, 28203, United States

Location

Duke University Medical Center

Durham, North Carolina, 27710, United States

Location

Forsyth Radiological Associates

Winston-Salem, North Carolina, 27103, United States

Location

Wake Forest University

Winston-Salem, North Carolina, 27157, United States

Location

Christ Hospital

Cincinnati, Ohio, 45219, United States

Location

University of Cincinnati

Cincinnati, Ohio, 45267, United States

Location

The Cleveland Clinic Lerner College Of Medicine of CWRU

Cleveland, Ohio, 44195, United States

Location

Midwest Ohio Health Research Institute

Columbus, Ohio, 43214, United States

Location

The Toledo Hospital

Toledo, Ohio, 43606, United States

Location

University of Toledo

Toledo, Ohio, 43614, United States

Location

Oklahoma Foundation for Cardiovascular Research

Oklahoma City, Oklahoma, 73120, United States

Location

Rogue Valley Medical Center

Medford, Oregon, 97504, United States

Location

Oregon Health Science University

Portland, Oregon, 97201, United States

Location

Lehigh Valley Hospital

Allentown, Pennsylvania, 18105, United States

Location

Heritage Valley Medical Group

Beaver, Pennsylvania, 15009, United States

Location

Geisinger Medical Center

Danville, Pennsylvania, 17822, United States

Location

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107, United States

Location

Allegheny Singer Research Institute

Pittsburgh, Pennsylvania, 15212, United States

Location

UPMC Presbyterian Shadyside

Pittsburgh, Pennsylvania, 15232, United States

Location

Rhode Island Hospital

Providence, Rhode Island, 02903, United States

Location

South Carolina Heart Center

Columbia, South Carolina, 29204, United States

Location

Metro Knoxville HMA

Knoxville, Tennessee, 37920, United States

Location

Baptist Memorial Hospital

Memphis, Tennessee, 38120, United States

Location

The University of Texas Southwestern Medical Center at Dallas

Dallas, Texas, 75390, United States

Location

Houston Methodist Hospital

Houston, Texas, 77030, United States

Location

UT Houston Memorial

Houston, Texas, 77030, United States

Location

Scott & White Memorial Hospital

Temple, Texas, 76508, United States

Location

Intermountain Health Services

Salt Lake City, Utah, 84143, United States

Location

University of Virginia

Charlottesville, Virginia, 22908, United States

Location

Swedish Health Services

Seattle, Washington, 98122, United States

Location

Providence Health & Services - Washington

Spokane, Washington, 99204, United States

Location

Charleston Area Medical Center

Charleston, West Virginia, 25304, United States

Location

Marshfield Clinic

Marshfield, Wisconsin, 54449, United States

Location

St. Luke's Medical Center

Milwaukee, Wisconsin, 53215, United States

Location

Governors of the University of Calgary and the Calgary Health Region

Calgary, Alberta, T2N 2T9, Canada

Location

The University of British Columbia and The Vancouver Coastal Health Authority

Vancouver, British Columbia, V5Z 3J5, Canada

Location

St. Boniface General Hospital

Winnipeg, Manitoba, R2H2A6, Canada

Location

The Credit Valley Hospital and Trillium Health Centre

Mississauga, Ontario, L5B 4A2, Canada

Location

Ottawa Hospital Research Institute

Ottawa, Ontario, K1H1A2, Canada

Location

St. Michael's Hospital

Toronto, Ontario, M5B 1W8, Canada

Location

University Health Network

Toronto, Ontario, M5T 2S8, Canada

Location

Lawson Health Research Institute

Toronto, Ontario, N6A5A5, Canada

Location

CHU de Québec

Québec, Quebec, G1J1Z4, Canada

Location

Related Publications (43)

  • Hopkins LN, Roubin GS, Chakhtoura EY, Gray WA, Ferguson RD, Katzen BT, Rosenfield K, Goldstein J, Cutlip DE, Morrish W, Lal BK, Sheffet AJ, Tom M, Hughes S, Voeks J, Kathir K, Meschia JF, Hobson RW 2nd, Brott TG. The Carotid Revascularization Endarterectomy versus Stenting Trial: credentialing of interventionalists and final results of lead-in phase. J Stroke Cerebrovasc Dis. 2010 Mar;19(2):153-62. doi: 10.1016/j.jstrokecerebrovasdis.2010.01.001.

    PMID: 20189092BACKGROUND
  • Howard VJ, Voeks JH, Lutsep HL, Mackey A, Milot G, Sam AD 2nd, Tom M, Hughes SE, Sheffet AJ, Longbottom M, Avery JB, Hobson RW 2nd, Brott TG. Does sex matter? Thirty-day stroke and death rates after carotid artery stenting in women versus men: results from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) lead-in phase. Stroke. 2009 Apr;40(4):1140-7. doi: 10.1161/STROKEAHA.108.541847. Epub 2009 Feb 10.

    PMID: 19211486BACKGROUND
  • Sheffet AJ, Roubin G, Howard G, Howard V, Moore W, Meschia JF, Hobson RW 2nd, Brott TG. Design of the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST). Int J Stroke. 2010 Feb;5(1):40-6. doi: 10.1111/j.1747-4949.2009.00405.x.

    PMID: 20088993BACKGROUND
  • Lal BK, Brott TG. The Carotid Revascularization Endarterectomy vs. Stenting Trial completes randomization: lessons learned and anticipated results. J Vasc Surg. 2009 Nov;50(5):1224-31. doi: 10.1016/j.jvs.2009.09.003.

    PMID: 19878793BACKGROUND
  • Hobson RW 2nd, Brott TG, Roubin GS, Silver FL, Barnett HJ. Carotid artery stenting: meeting the recruitment challenge of a clinical trial. Stroke. 2005 Jun;36(6):1314-5. doi: 10.1161/01.STR.0000165919.26944.05. Epub 2005 Apr 28. No abstract available.

    PMID: 15860747BACKGROUND
  • Hobson RW 2nd, Howard VJ, Roubin GS, Brott TG, Ferguson RD, Popma JJ, Graham DL, Howard G; CREST Investigators. Carotid artery stenting is associated with increased complications in octogenarians: 30-day stroke and death rates in the CREST lead-in phase. J Vasc Surg. 2004 Dec;40(6):1106-11. doi: 10.1016/j.jvs.2004.10.022.

    PMID: 15622363BACKGROUND
  • Hobson RW 2nd, Howard VJ, Roubin GS, Ferguson RD, Brott TG, Howard G, Sheffet AJ, Roberts J, Hopkins LN, Moore WS; CREST. Credentialing of surgeons as interventionalists for carotid artery stenting: experience from the lead-in phase of CREST. J Vasc Surg. 2004 Nov;40(5):952-7. doi: 10.1016/j.jvs.2004.08.039.

    PMID: 15557910BACKGROUND
  • Hobson RW 2nd, Howard VJ, Brott TG, Howard G, Roubin GS, Ferguson RD; For the CREST Executive Committee. Organizing the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): National Institutes of Health, Health Care Financing Administration, and industry funding. Curr Control Trials Cardiovasc Med. 2001 Jul 13;2(4):160-164. doi: 10.1186/cvm-2-4-160.

    PMID: 11806790BACKGROUND
  • Hobson RW 2nd, Brott T, Ferguson R, Roubin G, Moore W, Kuntz R, Howard G, Ferguson J. CREST: carotid revascularization endarterectomy versus stent trial. Cardiovasc Surg. 1997 Oct;5(5):457-8. doi: 10.1016/s0967-2109(97)00048-3. No abstract available.

    PMID: 9464598BACKGROUND
  • Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, Mackey A, Hill MD, Leimgruber PP, Sheffet AJ, Howard VJ, Moore WS, Voeks JH, Hopkins LN, Cutlip DE, Cohen DJ, Popma JJ, Ferguson RD, Cohen SN, Blackshear JL, Silver FL, Mohr JP, Lal BK, Meschia JF; CREST Investigators. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010 Jul 1;363(1):11-23. doi: 10.1056/NEJMoa0912321. Epub 2010 May 26.

  • Mantese VA, Timaran CH, Chiu D, Begg RJ, Brott TG; CREST Investigators. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke. 2010 Oct;41(10 Suppl):S31-4. doi: 10.1161/STROKEAHA.110.595330.

  • Silver FL, Mackey A, Clark WM, Brooks W, Timaran CH, Chiu D, Goldstein LB, Meschia JF, Ferguson RD, Moore WS, Howard G, Brott TG; CREST Investigators. Safety of stenting and endarterectomy by symptomatic status in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST). Stroke. 2011 Mar;42(3):675-80. doi: 10.1161/STROKEAHA.110.610212. Epub 2011 Feb 9.

  • Blackshear JL, Cutlip DE, Roubin GS, Hill MD, Leimgruber PP, Begg RJ, Cohen DJ, Eidt JF, Narins CR, Prineas RJ, Glasser SP, Voeks JH, Brott TG; CREST Investigators. Myocardial infarction after carotid stenting and endarterectomy: results from the carotid revascularization endarterectomy versus stenting trial. Circulation. 2011 Jun 7;123(22):2571-8. doi: 10.1161/CIRCULATIONAHA.110.008250. Epub 2011 May 23.

  • Vilain KR, Magnuson EA, Li H, Clark WM, Begg RJ, Sam AD 2nd, Sternbergh WC 3rd, Weaver FA, Gray WA, Voeks JH, Brott TG, Cohen DJ; CREST Investigators. Costs and cost-effectiveness of carotid stenting versus endarterectomy for patients at standard surgical risk: results from the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST). Stroke. 2012 Sep;43(9):2408-16. doi: 10.1161/STROKEAHA.112.661355. Epub 2012 Jul 19.

  • Lal BK, Beach KW, Roubin GS, Lutsep HL, Moore WS, Malas MB, Chiu D, Gonzales NR, Burke JL, Rinaldi M, Elmore JR, Weaver FA, Narins CR, Foster M, Hodgson KJ, Shepard AD, Meschia JF, Bergelin RO, Voeks JH, Howard G, Brott TG; CREST Investigators. Restenosis after carotid artery stenting and endarterectomy: a secondary analysis of CREST, a randomised controlled trial. Lancet Neurol. 2012 Sep;11(9):755-63. doi: 10.1016/S1474-4422(12)70159-X. Epub 2012 Aug 2.

  • Hill MD, Brooks W, Mackey A, Clark WM, Meschia JF, Morrish WF, Mohr JP, Rhodes JD, Popma JJ, Lal BK, Longbottom ME, Voeks JH, Howard G, Brott TG; CREST Investigators. Stroke after carotid stenting and endarterectomy in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Circulation. 2012 Dec 18;126(25):3054-61. doi: 10.1161/CIRCULATIONAHA.112.120030. Epub 2012 Nov 16.

  • Timaran CH, Mantese VA, Malas M, Brown OW, Lal BK, Moore WS, Voeks JH, Brott TG; CREST Investigators. Differential outcomes of carotid stenting and endarterectomy performed exclusively by vascular surgeons in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). J Vasc Surg. 2013 Feb;57(2):303-8. doi: 10.1016/j.jvs.2012.09.014. Epub 2012 Dec 20.

  • Matsumura JS, Hanlon BM, Rosenfield K, Voeks JH, Howard G, Roubin GS, Brott TG. Treatment of carotid stenosis in asymptomatic, nonoctogenarian, standard risk patients with stenting versus endarterectomy trials. J Vasc Surg. 2022 Apr;75(4):1276-1283.e1. doi: 10.1016/j.jvs.2021.10.020. Epub 2021 Oct 22.

  • Howard VJ, Algra A, Howard G, Bonati LH, de Borst GJ, Bulbulia R, Calvet D, Eckstein HH, Fraedrich G, Greving JP, Halliday A, Hendrikse J, Jansen O, Brown MM, Mas JL, Ringleb PA, Brott TG; Carotid Stenosis Trialists' Collaboration. Absence of Consistent Sex Differences in Outcomes From Symptomatic Carotid Endarterectomy and Stenting Randomized Trials. Stroke. 2021 Jan;52(2):416-423. doi: 10.1161/STROKEAHA.120.030184. Epub 2021 Jan 25.

  • Muller MD, von Felten S, Algra A, Becquemin JP, Bulbulia R, Calvet D, Eckstein HH, Fraedrich G, Halliday A, Hendrikse J, Howard G, Gregson J, Jansen O, Brown MM, Mas JL, Brott TG, Ringleb PA, Bonati LH. Secular Trends in Procedural Stroke or Death Risks of Stenting Versus Endarterectomy for Symptomatic Carotid Stenosis. Circ Cardiovasc Interv. 2019 Aug;12(8):e007870. doi: 10.1161/CIRCINTERVENTIONS.119.007870. Epub 2019 Aug 5.

  • Moore WS, Voeks JH, Roubin GS, Clark WM, Howard VJ, Jones MR, Brott TG; CREST Investigators. Duration of asymptomatic status and outcomes following carotid endarterectomy and carotid artery stenting in the Carotid Revascularization Endarterectomy vs Stenting Trial. J Vasc Surg. 2019 Jun;69(6):1797-1800. doi: 10.1016/j.jvs.2018.09.054. Epub 2019 Jan 8.

  • Jones MR, Howard G, Roubin GS, Blackshear JL, Cohen DJ, Cutlip DE, Leimgruber PP, Rhodes D, Prineas RJ, Glasser SP, Lal BK, Voeks JH, Brott TG; CREST Investigators. Periprocedural Stroke and Myocardial Infarction as Risks for Long-Term Mortality in CREST. Circ Cardiovasc Qual Outcomes. 2018 Nov;11(11):e004663. doi: 10.1161/CIRCOUTCOMES.117.004663.

  • Lal BK, Roubin GS, Jones M, Clark W, Mackey A, Hill MD, Voeks JH, Howard G, Hobson RW 2nd, Brott TG. Influence of multiple stents on periprocedural stroke after carotid artery stenting in the Carotid Revascularization Endarterectomy versus Stent Trial (CREST). J Vasc Surg. 2019 Mar;69(3):800-806. doi: 10.1016/j.jvs.2018.06.221. Epub 2018 Dec 4.

  • Muller MD, von Felten S, Algra A, Becquemin JP, Brown M, Bulbulia R, Calvet D, Eckstein HH, Fraedrich G, Halliday A, Hendrikse J, Gregson J, Howard G, Jansen O, Mas JL, Brott TG, Ringleb PA, Bonati LH; Carotid Stenosis Trialists' Collaboration. Immediate and Delayed Procedural Stroke or Death in Stenting Versus Endarterectomy for Symptomatic Carotid Stenosis. Stroke. 2018 Nov;49(11):2715-2722. doi: 10.1161/STROKEAHA.118.020684.

  • Sheffet AJ, Howard G, Sam A, Jamil Z, Weaver F, Chiu D, Voeks JH, Howard VJ, Hughes SE, Flaxman L, Longbottom ME, Brott TG; CREST Investigators. Challenge and Yield of Enrolling Racially and Ethnically Diverse Patient Populations in Low Event Rate Clinical Trials. Stroke. 2018 Jan;49(1):84-89. doi: 10.1161/STROKEAHA.117.018063. Epub 2017 Nov 30.

  • Rantner B, Kollerits B, Roubin GS, Ringleb PA, Jansen O, Howard G, Hendrikse J, Halliday A, Gregson J, Eckstein HH, Calvet D, Bulbulia R, Bonati LH, Becquemin JP, Algra A, Brown MM, Mas JL, Brott TG, Fraedrich G; Carotid Stenosis Trialists' Collaboration. Early Endarterectomy Carries a Lower Procedural Risk Than Early Stenting in Patients With Symptomatic Stenosis of the Internal Carotid Artery: Results From 4 Randomized Controlled Trials. Stroke. 2017 Jun;48(6):1580-1587. doi: 10.1161/STROKEAHA.116.016233. Epub 2017 Apr 28.

  • Brott TG, Howard G, Roubin GS, Meschia JF, Mackey A, Brooks W, Moore WS, Hill MD, Mantese VA, Clark WM, Timaran CH, Heck D, Leimgruber PP, Sheffet AJ, Howard VJ, Chaturvedi S, Lal BK, Voeks JH, Hobson RW 2nd; CREST Investigators. Long-Term Results of Stenting versus Endarterectomy for Carotid-Artery Stenosis. N Engl J Med. 2016 Mar 17;374(11):1021-31. doi: 10.1056/NEJMoa1505215. Epub 2016 Feb 18.

  • Moore WS, Popma JJ, Roubin GS, Voeks JH, Cutlip DE, Jones M, Howard G, Brott TG; CREST Investigators. Carotid angiographic characteristics in the CREST trial were major contributors to periprocedural stroke and death differences between carotid artery stenting and carotid endarterectomy. J Vasc Surg. 2016 Apr;63(4):851-7, 858.e1. doi: 10.1016/j.jvs.2015.08.119. Epub 2015 Nov 21.

  • Meschia JF, Hopkins LN, Altafullah I, Wechsler LR, Stotts G, Gonzales NR, Voeks JH, Howard G, Brott TG. Time From Symptoms to Carotid Endarterectomy or Stenting and Perioperative Risk. Stroke. 2015 Dec;46(12):3540-2. doi: 10.1161/STROKEAHA.115.011123. Epub 2015 Oct 22.

  • Voeks JH, Howard G, Roubin G, Farb R, Heck D, Logan W, Longbottom M, Sheffet A, Meschia JF, Brott TG. Mediators of the Age Effect in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST). Stroke. 2015 Oct;46(10):2868-73. doi: 10.1161/STROKEAHA.115.009516. Epub 2015 Sep 8.

  • Howard G, Hopkins LN, Moore WS, Katzen BT, Chakhtoura E, Morrish WF, Ferguson RD, Hye RJ, Shawl FA, Harrigan MR, Voeks JH, Howard VJ, Lal BK, Meschia JF, Brott TG. Temporal Changes in Periprocedural Events in the Carotid Revascularization Endarterectomy Versus Stenting Trial. Stroke. 2015 Aug;46(8):2183-9. doi: 10.1161/STROKEAHA.115.008898. Epub 2015 Jul 14.

  • Sheffet AJ, Voeks JH, Mackey A, Brooks W, Clark WM, Hill MD, Howard VJ, Hughes SE, Tom M, Longbottom ME, Brott TG; CREST Investigators. Characteristics of participants consenting versus declining follow-up for up to 10 years in a randomized clinical trial. Clin Trials. 2015 Dec;12(6):657-63. doi: 10.1177/1740774515590807. Epub 2015 Jun 29.

  • Malas M, Glebova NO, Hughes SE, Voeks JH, Qazi U, Moore WS, Lal BK, Howard G, Llinas R, Brott TG. Effect of patching on reducing restenosis in the carotid revascularization endarterectomy versus stenting trial. Stroke. 2015 Mar;46(3):757-61. doi: 10.1161/STROKEAHA.114.007634. Epub 2015 Jan 22.

  • Meschia JF, Voeks JH, Leimgruber PP, Mantese VA, Timaran CH, Chiu D, Demaerschalk BM, Howard VJ, Hughes SE, Longbottom M, Howard AG, Brott TG. Management of vascular risk factors in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST). J Am Heart Assoc. 2014 Nov 26;3(6):e001180. doi: 10.1161/JAHA.114.001180.

  • Gonzales NR, Demaerschalk BM, Voeks JH, Tom M, Howard G, Sheffet AJ, Garcia L, Clair DG, Barr J, Orlow S, Brott TG; CREST Investigators. Complication rates and center enrollment volume in the carotid revascularization endarterectomy versus stenting trial. Stroke. 2014 Nov;45(11):3320-4. doi: 10.1161/STROKEAHA.114.006228. Epub 2014 Sep 25.

  • Howard G, Voeks JH, Meschia JF, Howard VJ, Brott TG. Picking the good apples: statistics versus good judgment in choosing stent operators for a multicenter clinical trial. Stroke. 2014 Nov;45(11):3325-9. doi: 10.1161/STROKEAHA.114.006807. Epub 2014 Sep 11.

  • Sheffet AJ, Flaxman L, Tom M, Hughes SE, Longbottom ME, Howard VJ, Marler JR, Brott TG; CREST Investigators. Financial management of a large multisite randomized clinical trial. Int J Stroke. 2014 Aug;9(6):811-3. doi: 10.1111/ijs.12259. Epub 2014 Mar 24.

  • Zierler RE, Beach KW, Bergelin RO, Lal BK, Moore WS, Roubin GS, Voeks JH, Brott TG; CREST Investigators. Agreement between site-reported and ultrasound core laboratory results for duplex ultrasound velocity measurements in the Carotid Revascularization Endarterectomy versus Stenting Trial. J Vasc Surg. 2014 Jan;59(1):2-7. doi: 10.1016/j.jvs.2013.06.071. Epub 2013 Sep 19.

  • Habersberger J, Brott TG, Roubin GS. Carotid artery stenting: a clinical update. Curr Opin Cardiol. 2012 Nov;27(6):565-71. doi: 10.1097/HCO.0b013e3283587506.

  • Voeks JH, Howard G, Roubin GS, Malas MB, Cohen DJ, Sternbergh WC 3rd, Aronow HD, Eskandari MK, Sheffet AJ, Lal BK, Meschia JF, Brott TG; CREST Investigators. Age and outcomes after carotid stenting and endarterectomy: the carotid revascularization endarterectomy versus stenting trial. Stroke. 2011 Dec;42(12):3484-90. doi: 10.1161/STROKEAHA.111.624155. Epub 2011 Oct 6.

  • Cohen DJ, Stolker JM, Wang K, Magnuson EA, Clark WM, Demaerschalk BM, Sam AD Jr, Elmore JR, Weaver FA, Aronow HD, Goldstein LB, Roubin GS, Howard G, Brott TG; CREST Investigators. Health-related quality of life after carotid stenting versus carotid endarterectomy: results from CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial). J Am Coll Cardiol. 2011 Oct 4;58(15):1557-65. doi: 10.1016/j.jacc.2011.05.054.

  • Chimowitz MI, Lynn MJ, Derdeyn CP, Turan TN, Fiorella D, Lane BF, Janis LS, Lutsep HL, Barnwell SL, Waters MF, Hoh BL, Hourihane JM, Levy EI, Alexandrov AV, Harrigan MR, Chiu D, Klucznik RP, Clark JM, McDougall CG, Johnson MD, Pride GL Jr, Torbey MT, Zaidat OO, Rumboldt Z, Cloft HJ; SAMMPRIS Trial Investigators. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med. 2011 Sep 15;365(11):993-1003. doi: 10.1056/NEJMoa1105335. Epub 2011 Sep 7.

  • Howard VJ, Lutsep HL, Mackey A, Demaerschalk BM, Sam AD 2nd, Gonzales NR, Sheffet AJ, Voeks JH, Meschia JF, Brott TG; CREST investigators. Influence of sex on outcomes of stenting versus endarterectomy: a subgroup analysis of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Lancet Neurol. 2011 Jun;10(6):530-7. doi: 10.1016/S1474-4422(11)70080-1. Epub 2011 May 5.

MeSH Terms

Conditions

AtherosclerosisStrokeCarotid StenosisCerebral InfarctionMyocardial InfarctionConstriction, PathologicIschemic Attack, Transient

Interventions

Endarterectomy, Carotid

Condition Hierarchy (Ancestors)

ArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular DiseasesCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesCarotid Artery DiseasesBrain InfarctionBrain IschemiaInfarctionIschemiaPathologic ProcessesPathological Conditions, Signs and SymptomsNecrosisMyocardial IschemiaHeart DiseasesPathological Conditions, Anatomical

Intervention Hierarchy (Ancestors)

EndarterectomyVascular Surgical ProceduresCardiovascular Surgical ProceduresSurgical Procedures, Operative

Results Point of Contact

Title
Thomas G. Brott, MD - Principal Investigator
Organization
Mayo Clinic

Study Officials

  • Thomas G. Brott, M.D.

    Mayo Clinic and Rutgers University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 25, 2000

First Posted

February 28, 2000

Study Start

December 1, 2000

Primary Completion

February 1, 2011

Study Completion

December 1, 2016

Last Updated

May 17, 2017

Results First Posted

December 10, 2013

Record last verified: 2017-04

Data Sharing

IPD Sharing
Will not share

Locations