Carotid Revascularization Endarterectomy Versus Stenting Trial
NCT ID: NCT00004732
Last Updated: 2017-05-17
Study Results
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View full resultsBasic Information
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COMPLETED
NA
2502 participants
INTERVENTIONAL
2000-12-31
2016-12-31
Brief Summary
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Detailed Description
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The RX ACCUNET(TM) Embolic Protection System (an umbrella-like device that expands above the narrowed portion of the carotid artery) will be used in conjunction with the RX ACCULINK stent. The RX ACCUNET system is designed to capture embolic material that could break off from the narrowed area in the carotid artery while still allowing blood to flow through the vessel during the procedure. Embolic material could block blood flow to the arteries beyond the narrowing and be harmful to the brain. The RX ACCUNET System is closed and removed after the stent is placed.
CEA involves a neck incision and physical removal of the plaque from the inside of the artery. 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. The stent is then placed to cover the plaque and hold the artery open. Participants will be randomly assigned to undergo either CAS or CEA, and all patients will receive best medical management, which includes treatment with aspirin, treatment of high blood pressure, and treatment of other stroke risk factors. Participants will be followed for up to ten years.
With the simplification of the protocol for long-term follow-up, the focus for secondary outcomes is to assess restenosis and viability of the procedure. Restenosis rates on an annual basis in both the endarterectomy and stenting arms of the study will be assessed using carotid duplex ultrasound exams performed annually (standard of care).
In addition to restenosis, the "viability" of the procedures will be assessed by the need (or lack of need) for repeat revascularization (either open surgical or endovascular) after the index procedure. The question "has a new carotid intervention been performed since last follow-up" will be asked at every contact with the patient. If answered positively, additional data will be collected on the appropriate case report forms(CRFs).
LINKAGE OF CREST COHORT WITH CENTERS FOR MEDICAID AND MEDICARE SERVICES(CMS) ADMINISTRATIVE DATA
The purpose of linking Medicare-eligible CREST participants with CMS data files is to assess patient outcomes and utilization of health care services. This plan to link in- and out-patient episodes of care using national Medicare data establishes a new resource that will enhance current follow-up strategies, as well as explore alternative strategies to ascertain patient outcomes for future clinical studies.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
DOUBLE
Study Groups
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Carotid Artery Endarterectomy (CEA)
Carotid endarterectomy is surgery to remove plaque buildup that causes narrowing (stenosis) in the carotid artery.
Carotid Endarterectomy (CEA)
CEA involves a neck incision and physical removal of the plaque from the inside of the carotid artery.
Carotid Artery Stenting (CAS)
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.
Carotid Artery Stenting (CAS)
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.
Interventions
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Carotid Endarterectomy (CEA)
CEA involves a neck incision and physical removal of the plaque from the inside of the carotid artery.
Carotid Artery Stenting (CAS)
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.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* 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.
Exclusion Criteria
18 Years
ALL
No
Sponsors
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National Institute of Neurological Disorders and Stroke (NINDS)
NIH
University of Alabama at Birmingham
OTHER
Rutgers, The State University of New Jersey
OTHER
Responsible Party
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Principal Investigators
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Thomas G. Brott, M.D.
Role: PRINCIPAL_INVESTIGATOR
Mayo Clinic and Rutgers University
Locations
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The Board of Trustees of the University of Alabama for the University of Alabama at Birmingham
Birmingham, Alabama, United States
Dignity Health dba St. Joseph's Hospital & Medical Center
Phoenix, Arizona, United States
Mayo Clinic Arizona
Scottsdale, Arizona, United States
The Arizona Board of Regents for the University of Arizona
Tucson, Arizona, United States
Board of Trustees of the University of Arkansas
Little Rock, Arkansas, United States
USC University Hospital & LA County Hospital
Los Angeles, California, United States
The Regents of the University of California
Los Angeles, California, United States
Kaiser Permanente Medical Center
San Diego, California, United States
Northern California Institute for Research and Education
San Francisco, California, United States
Catholic Healthcare West
Stockton, California, United States
Christiana Care Health Services, Inc.
Newark, Delaware, United States
Morton Plant Hospital
Clearwater, Florida, United States
Mayo Clinic
Jacksonville, Florida, United States
Leesburg Medical Center
Leesburg, Florida, United States
Miami Cardiac & Vascular Institute of Baptist Hospital of Miami, Inc.
Miami, Florida, United States
Florida Hospital Neuroscience Institute, a division of Adventist Health System/Sunbelt, Inc.
Orlando, Florida, United States
Orlando Regional Medical Center
Orlando, Florida, United States
University of South Florida Board of Trustees
Tampa, Florida, United States
Piedmont Hospital/Fuqua Heart Center
Atlanta, Georgia, United States
Emory University
Atlanta, Georgia, United States
St. Joseph's of Atlanta
Atlanta, Georgia, United States
St. Joseph's Candler Health System
Savannah, Georgia, United States
Norwestern Memorial Hospital
Chicago, Illinois, United States
Alexian Brothers Specialty Group
Elk Grove Village, Illinois, United States
Loyola University of Chicago
Maywood, Illinois, United States
Peoria Radiology Research and Education
Peoria, Illinois, United States
Prarie Cardiology-St. John's Hospital
Springfield, Illinois, United States
Southern Illinois School of Medicine
Springfield, Illinois, United States
Central Dupage Hospital
Winfield, Illinois, United States
Lutheran Medical Group, LLC,
Fort Wayne, Indiana, United States
Parkview Hospital, Inc.
Fort Wayne, Indiana, United States
St. Vincent's Hospital
Indianapolis, Indiana, United States
Catholic Health Initiatives /Mercy Hospital Center
Des Moines, Iowa, United States
Baptist Healthcare System, Inc.
Lexington, Kentucky, United States
Vascular Surgery Associates
Baton Rouge, Louisiana, United States
Ochsner Foundation Hospital
New Orleans, Louisiana, United States
Anne Arundel Health System Research Institute
Annapolis, Maryland, United States
Johns Hopkins University
Baltimore, Maryland, United States
Adventist Healthcare, Inc.
Takoma Park, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Steward St. Elizabeth's Medical Center of Boston, Inc.
Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Brigham and Womens Hospital, Inc.
Boston, Massachusetts, United States
Cape Cod Health Care, Inc.,
Hyannis, Massachusetts, United States
University of Michigan
Ann Arbor, Michigan, United States
Henry Ford Health System
Detroit, Michigan, United States
St. John Hospital and Medical Center
Detroit, Michigan, United States
Michigan Vascular Research Center
Flint, Michigan, United States
Spectrum Health Hospital
Grand Rapids, Michigan, United States
William Beaumont Hospital
Royal Oak, Michigan, United States
Providence St. John Hopital
Southfield, Michigan, United States
Michigan Heart & Vascular Institute/St. Joseph's Mercy Hospital
Ypsilanti, Michigan, United States
North Memorial Health Care
Robbinsdale, Minnesota, United States
Mayo Clinic Rochester/St. Mary's
Rochester, Minnesota, United States
Mississippi Baptist Medical Center, Inc.
Jackson, Mississippi, United States
Heartland Physician Services, LLC
Kansas City, Missouri, United States
Mercy Hospitals East Communities
St Louis, Missouri, United States
St. Patrick's Hospital International Heart Institute of MT
Missoula, Montana, United States
Dartmouth College and the constituent members of DARTMOUTH HITCHCOCK MEDICAL CENTER
Lebanon, New Hampshire, United States
St. Michael's Medical Center
Newark, New Jersey, United States
Center for Vascular Awareness, Inc.
Albany, New York, United States
Millard Fillmore SUNY Buffalo
Buffalo, New York, United States
NYU School of Medicine
New York, New York, United States
The Feinstein Institute for Medical Research
New York, New York, United States
Weill Medical College of Cornell University
New York, New York, United States
Columbia Presbyterian
New York, New York, United States
St. Francis Hospital
Port Washington, New York, United States
University of Rochester
Rochester, New York, United States
Richmond University Medical Center
Staten Island, New York, United States
Westchester Medical Center
Valhalla, New York, United States
UNC at Chapel Hill
Chapel Hill, North Carolina, United States
The Charlotte-Mecklenburg Hospital Authority
Charlotte, North Carolina, United States
Duke University Medical Center
Durham, North Carolina, United States
Forsyth Radiological Associates
Winston-Salem, North Carolina, United States
Wake Forest University
Winston-Salem, North Carolina, United States
Christ Hospital
Cincinnati, Ohio, United States
University of Cincinnati
Cincinnati, Ohio, United States
The Cleveland Clinic Lerner College Of Medicine of CWRU
Cleveland, Ohio, United States
Midwest Ohio Health Research Institute
Columbus, Ohio, United States
The Toledo Hospital
Toledo, Ohio, United States
University of Toledo
Toledo, Ohio, United States
Oklahoma Foundation for Cardiovascular Research
Oklahoma City, Oklahoma, United States
Rogue Valley Medical Center
Medford, Oregon, United States
Oregon Health Science University
Portland, Oregon, United States
Lehigh Valley Hospital
Allentown, Pennsylvania, United States
Heritage Valley Medical Group
Beaver, Pennsylvania, United States
Geisinger Medical Center
Danville, Pennsylvania, United States
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, United States
Allegheny Singer Research Institute
Pittsburgh, Pennsylvania, United States
UPMC Presbyterian Shadyside
Pittsburgh, Pennsylvania, United States
Rhode Island Hospital
Providence, Rhode Island, United States
South Carolina Heart Center
Columbia, South Carolina, United States
Metro Knoxville HMA
Knoxville, Tennessee, United States
Baptist Memorial Hospital
Memphis, Tennessee, United States
The University of Texas Southwestern Medical Center at Dallas
Dallas, Texas, United States
Houston Methodist Hospital
Houston, Texas, United States
UT Houston Memorial
Houston, Texas, United States
Scott & White Memorial Hospital
Temple, Texas, United States
Intermountain Health Services
Salt Lake City, Utah, United States
University of Virginia
Charlottesville, Virginia, United States
Swedish Health Services
Seattle, Washington, United States
Providence Health & Services - Washington
Spokane, Washington, United States
Charleston Area Medical Center
Charleston, West Virginia, United States
Marshfield Clinic
Marshfield, Wisconsin, United States
St. Luke's Medical Center
Milwaukee, Wisconsin, United States
Governors of the University of Calgary and the Calgary Health Region
Calgary, Alberta, Canada
The University of British Columbia and The Vancouver Coastal Health Authority
Vancouver, British Columbia, Canada
St. Boniface General Hospital
Winnipeg, Manitoba, Canada
The Credit Valley Hospital and Trillium Health Centre
Mississauga, Ontario, Canada
Ottawa Hospital Research Institute
Ottawa, Ontario, Canada
St. Michael's Hospital
Toronto, Ontario, Canada
University Health Network
Toronto, Ontario, Canada
Lawson Health Research Institute
Toronto, Ontario, Canada
CHU de Québec
Québec, Quebec, Canada
Countries
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References
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
0119970017
Identifier Type: -
Identifier Source: org_study_id
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