Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial
NCT ID: NCT02089217
Last Updated: 2025-10-01
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
2486 participants
INTERVENTIONAL
2014-12-09
2025-09-12
Brief Summary
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Detailed Description
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The purpose of this trial is to determine the best way to prevent strokes in people who have a high amount of blockage of their carotid artery but no stroke symptoms related to that blockage. Each eligible participant will be evaluated to determine which procedure(s) is best for him/her. All participants will receive intensive medical treatment. In addition, participants will be randomized to receive the selected procedure or not.
The trial will be conducted in the United States and Canada by physicians carefully selected on their ability to perform the procedures at low risk. Another key component of the trial is that important stroke risk factors, including hypertension, diabetes, high cholesterol, cigarette smoking, physical activity, and diet will be managed intensively. Participants will remain in the study for 4 years.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
SINGLE
Study Groups
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Carotid Endarterectomy (CEA)
Carotid Endarterectomy
Carotid endarterectomy (CEA)
Carotid endarterectomy
Carotid Stenting (CAS)
Carotid Stenting
Carotid Stenting (CAS)
Carotid stenting
Intensive Medical Management - no CEA
Intensive Medical Management alone - no CEA
Intensive Medical Management - no CEA
Intensive Medical Management alone - no CEA
Intensive Medical Management - no CAS
Intensive Medical Management alone - no CAS
Intensive Medical Management - no CAS
Intensive Medical Management alone - no CAS
Interventions
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Carotid endarterectomy (CEA)
Carotid endarterectomy
Carotid Stenting (CAS)
Carotid stenting
Intensive Medical Management - no CEA
Intensive Medical Management alone - no CEA
Intensive Medical Management - no CAS
Intensive Medical Management alone - no CAS
Eligibility Criteria
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Inclusion Criteria
2. Carotid stenosis defined as:
* Stenosis ≥70% by catheter angiography (NASCET Criteria); OR
* by Doppler ultrasonography (DUS) with ≥70% stenosis defined by a peak systolic velocity of at least 230 cm/s plus at least one of the following:
1. an end diastolic velocity ≥100 cm/s, or
2. internal carotid/common carotid artery peak systolic velocity ratio ≥4.0, or
3. computed tomography angiography (CTA) with ≥ 70% stenosis, or
4. magnetic resonance angiography (MRA) with ≥ 70% stenosis.
3. No medical history of stroke or transient ischemic attack (TIA) ipsilateral to the stenosis within 180 days of randomization. Life-long asymptomatic patients will be defined as having no medical history of stroke or transient ischemic attack and negative responses to all of the symptom items on the Questionnaire for Verifying Stroke-free Status (QVSS).
4. Patients must have a modified Rankin Scale (mRS) score of 0 or 1 at the time of informed consent.
5. Women must not be of childbearing potential or, if of childbearing potential, have a negative pregnancy test prior to randomization.
6. Patients must agree to comply with all protocol-specified follow-up appointments.
7. Patients must sign a consent form that has been approved by the local governing Institutional Review Board (IRB)/Medical Ethics Committee (MEC) of the respective clinical site.
8. Randomization to treatment group will apply to only one carotid artery for patients with bilateral carotid stenosis. Management of the non-randomized stenosis may be done in accordance with local PI recommendation. Treatment of the non-study internal carotid artery must take place at least 30 days prior to randomization, or greater than 44 days after randomization and 30 days after the study procedure is completed (whichever is longer).
9. Carotid stenosis must be treatable with carotid endarterectomy (CEA), carotid artery stenting (CAS), or either procedure.
Exclusion Criteria
2. GI hemorrhage within 1 month prior to enrollment that would preclude antiplatelet therapy.
3. Prior major ipsilateral stroke in the past with substantial residual disability (mRS ≥ 2) that is likely to confound study outcomes.
4. Severe dementia.
5. History of major symptomatic intracranial hemorrhage within 12 months that was not related to anticoagulation.
6. Prior Intracranial hemorrhage that the investigator believes represents a contraindication to the perioperative or periprocedural antithrombotic and antiplatelet treatments necessary to complete endarterectomy or stenting per protocol.
7. Current neurologic illness characterized by fleeting or fixed neurologic deficits that cannot be distinguished from TIA or stroke.
8. Patient objects to future blood transfusions.
9. Platelet count \<100,000/microliter or history of heparin-induced thrombocytopenia.
10. Anticoagulation with Phenprocoumon (Marcumar®), warfarin, or a direct thrombin inhibitor, or anti-Xa agents.
11. Chronic atrial fibrillation, unless the patient has had successful atrial appendage closure (e.g., Watchman Device) and no longer requires chronic therapeutic anticoagulation.
12. Any episode of atrial fibrillation within the past 6 months or history of paroxysmal atrial fibrillation that is deemed to require chronic anticoagulation.
13. Other high-risk cardiac sources of emboli, including left ventricular aneurysm, severe cardiomyopathy, aortic or mitral mechanical heart valve, severe calcific aortic stenosis (valve area \< 1.0 cm2), endocarditis, moderate to severe mitral stenosis, left atrial thrombus, or any intracardiac mass, or known unrepaired patent foramen ovale (PFO) with prior paradoxical embolism.
14. Unstable angina defined as rest angina with electrocardiogram (ECG) changes that is not amenable to revascularization (patients should undergo planned coronary revascularization at least 30 days before randomization).
15. Left Ventricular Ejection fraction \<30% or admission for heart failure in prior 6 months.
16. Respiratory insufficiency with life expectancy \< 4 years or forced expiratory volume (FEV1) \<30% of predicted value.
17. Known malignancy other than basal cell non-melanoma skin cancer. There are two exceptions to this rule: patients with prior cancer treatment and no recurrence for \>5 years are eligible for enrollment and cancer patients with life expectancy of greater than 5 years are eligible for enrollment.
18. Any major surgery, major trauma, revascularization procedure, or acute coronary syndrome within the past 1 month.
19. Either the serum creatinine is ≥ 2.5 mg/dl or the estimated glomerular filtration rate (GFR) is \< 30 cc/min.
20. Major (non-carotid) surgery/procedures planned within 3 months after enrollment.
21. Currently listed or being evaluated for major organ transplantation (i.e. heart, lung, liver, kidney).
22. Actively participating in another drug or aortic arch or cerebrovascular device trial for which participation in CREST-2 would be compromised with regard to follow-up assessment of outcomes or continuation in CREST-2.
23. Inability to understand and cooperate with study procedures or provide informed consent.
24. Non-atherosclerotic carotid stenosis (dissection, fibromuscular dysplasia, or stenosis following radiation therapy).
25. Previous ipsilateral CEA or CAS.
26. Ipsilateral internal or common carotid artery occlusion.
27. Intra-carotid floating thrombus.
28. Ipsilateral intracranial aneurysm \> 5 mm.
29. Extreme morbid obesity that would compromise patient safety during the procedure or would compromise patient safety during the periprocedural period.
30. Coronary artery disease with two or more proximal or major diseased coronary arteries with 70% stenosis that have not, or cannot, be revascularized.
Patients who are being considered for revascularization by CEA must not have any of the following criteria:
1. Serious adverse reaction to anesthesia not able to be overcome by pre-medication.
2. Distal/intracranial stenosis greater than index lesion.
3. Any of the following anatomical: radical neck dissection; surgically inaccessible lesions (e.g. above cervical spine level 2 (C2)); adverse neck anatomy that limits surgical exposure (e.g. spinal immobility - inability to flex neck beyond neutral or kyphotic deformity, or short obese neck); presence of tracheostomy stoma; laryngeal nerve palsy contralateral to target vessel; or previous extracranial-intracranial or subclavian bypass procedure ipsilateral to the target vessel.
Patients who are being considered for revascularization by CAS must not have any of the following criteria:
1. Allergy to intravascular contrast dye not amenable to pre-medication.
2. Type III, aortic arch anatomy.
3. Angulation or tortuosity (≥ 90 degree) of the innominate and common carotid artery that precludes safe, expeditious sheath placement or that will transmit a severe loop to the internal carotid after sheath placement.
4. Severe angulation or tortuosity of the internal carotid artery (including calyceal origin from the carotid bifurcation) that precludes safe deployment of embolic protection device or stent. Severe tortuosity is defined as 2 or more ≥ 90 degree angles within 4 cm of the target stenosis.
5. Proximal/ostial common carotid artery (CCA), innominate stenosis or distal/intracranial stenosis greater than index lesion.
Excessive circumferential calcification of the stenotic lesion defined as \>3mm thickness of calcification seen in orthogonal views on fluoroscopy.(Note: Anatomic considerations such as tortuosity, arch anatomy, and calcification must be evaluated even more carefully in elderly subjects (≥ 70 years).)
6. Target ICA vessel reference diameter \<4.0 mm or \>9.0 mm. Target internal carotid artery (ICA) measurements may be made from angiography of the contralateral artery. The reference diameter must be appropriate for the devices to be used.
7. Inability to deploy or utilize an FDA-approved Embolic Protection Device (EPD).
8. Non-contiguous lesions and long lesions (\>3 cm).
9. Qualitative characteristics of stenosis and stenosis-length of the carotid bifurcation (common carotid) and/or ipsilateral external carotid artery, that preclude safe sheath placement.
10. Occlusive or critical ilio-femoral disease including severe tortuosity or stenosis that necessitates additional endovascular procedures to facilitate access to the aortic arch or that prevents safe and expeditious femoral access to the aortic arch. "String sign" of the ipsilateral common or internal carotid artery.
11. Angiographic, computed tomography (CT), magnetic resonance (MR) or ultrasound evidence of severe atherosclerosis of the aortic arch or origin of the innominate or common carotid arteries that would preclude safe passage of the sheath and other endovascular devices to the target artery as needed for carotid stenting.
35 Years
100 Years
ALL
No
Sponsors
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National Institute of Neurological Disorders and Stroke (NINDS)
NIH
Mayo Clinic
OTHER
Responsible Party
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James F. Meschia
Principal Investigator
Principal Investigators
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James F. Meschia, MD
Role: PRINCIPAL_INVESTIGATOR
Mayo Clinic
Brajesh K. Lal, MD
Role: PRINCIPAL_INVESTIGATOR
University of Maryland
George Howard, DrPH
Role: PRINCIPAL_INVESTIGATOR
University of Alabama at Birmingham
Lloyd Edwards, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Alabama at Birmingham
Locations
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The University of Alabama at Birmingham
Birmingham, Alabama, United States
Huntsville Hospital/ Heart Center Research Alabama
Huntsville, Alabama, United States
Banner University Medical Center
Phoenix, Arizona, United States
St. Joseph's Hospital and Medical Center/Barrow Neurological Institute
Phoenix, Arizona, United States
Abrazo Arizona Heart Hospital
Phoenix, Arizona, United States
Mayo Clinic Arizona
Phoenix, Arizona, United States
HonorHealth Scottsdale Osborn Medical Center
Scottsdale, Arizona, United States
Banner University Medical Center
Tucson, Arizona, United States
Central Arkansas Veteran's Healthcare System
Little Rock, Arkansas, United States
Mission Cardiovascular Research Institute
Fremont, California, United States
Mission Cardiovascular Research
Fremont, California, United States
University of California Irvine
Irvine, California, United States
UC San Diego Health
La Jolla, California, United States
Kaiser Permanente Los Angeles
Los Angeles, California, United States
Keck Medical Center of University of Southern California
Los Angeles, California, United States
Cedars-Sinai Medical Center
Los Angeles, California, United States
University of California Los Angeles (UCLA)
Los Angeles, California, United States
VA Palo Alto Health Care System
Palo Alto, California, United States
University of California San Diego
San Diego, California, United States
Kaiser Permanente
San Diego, California, United States
Kaiser Permanente Northern California
San Francisco, California, United States
University of California San Francisco
San Francisco, California, United States
San Francisco VA Medical Center
San Francisco, California, United States
Stanford University Medical Center
Stanford, California, United States
St. Joseph's Medical Center
Stockton, California, United States
Providence Little Company of Mary Medical Center
Torrance, California, United States
St. Mary's Hospital Regional Medical Center
Grand Junction, Colorado, United States
Medical Center of the Rockies
Loveland, Colorado, United States
Hartford Hospital
Hartford, Connecticut, United States
Yale New Haven Hospital
New Haven, Connecticut, United States
Medstar/Washington Hospital Center
Washington D.C., District of Columbia, United States
Morton Plant Hospital
Clearwater, Florida, United States
University of Florida Health at Shands
Gainesville, Florida, United States
Lyerly Neurosurgery
Jacksonville, Florida, United States
UF Jacksonville
Jacksonville, Florida, United States
First Coast Cardiovascular Institute
Jacksonville, Florida, United States
Mayo Clinic
Jacksonville, Florida, United States
University of Miami Hospital
Miami, Florida, United States
Miami Cardiac and Vascular Institute at Baptist Hospital of Miami
Miami, Florida, United States
Mount Sinai Medical Center of Florida
Miami Beach, Florida, United States
Cardiovascular Institute of Northwest Florida
Panama City, Florida, United States
Tallahassee Neurological Clinic
Tallahassee, Florida, United States
Tampa General/University of South Florida
Tampa, Florida, United States
Atlanta VA Medical Center
Atlanta, Georgia, United States
Emory University
Atlanta, Georgia, United States
Southern Illinois Healthcare
Carbondale, Illinois, United States
The University of Chicago Medical Center
Chicago, Illinois, United States
Northshore University
Evanston, Illinois, United States
Northwestern University
Evanston, Illinois, United States
Loyola University Medical Center
Maywood, Illinois, United States
Mercy Health Riverside
Rockford, Illinois, United States
Prairie Heart/St. John's Hospital
Springfield, Illinois, United States
Franciscan St. Francis Health
Indianapolis, Indiana, United States
Deaconess Heart Group
Newburgh, Indiana, United States
University of Iowa Hospitals & Clinics
Iowa City, Iowa, United States
University of Kansas Medical Center
Kansas City, Kansas, United States
Baptist Health Lexington
Lexington, Kentucky, United States
University of Kentucky Hospital
Lexington, Kentucky, United States
University of Louisville Hospital
Louisville, Kentucky, United States
Tulane University Heart and Vascular
New Orleans, Louisiana, United States
Ochsner Health System
New Orleans, Louisiana, United States
Maine Medical Center
Portland, Maine, United States
University of Maryland VA
Baltimore, Maryland, United States
Johns Hopkins Medical Institution
Baltimore, Maryland, United States
White Oak Medical Center
Takoma Park, Maryland, United States
St. Elizabeth's Medical Center
Boston, Massachusetts, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center (BIDMC)
Boston, Massachusetts, United States
University of Massachusetts Memorial Hospital
Worcester, Massachusetts, United States
VA Ann Arbor Healthcare System
Ann Arbor, Michigan, United States
University of Michigan Hospital and Health Systems
Ann Arbor, Michigan, United States
Henry Ford Health System
Detroit, Michigan, United States
Michigan Vascular Center/McLaren- Flint
Flint, Michigan, United States
Sparrow Clinical Research Institute
Lansing, Michigan, United States
Cardiac and Vascular Research Center of Northern Michigan/McLaren Northern Michigan
Petoskey, Michigan, United States
William Beaumont Hospital
Royal Oak, Michigan, United States
Trinity Health/Michigan Heart
Ypsilanti, Michigan, United States
Minneapolis Clinic of Neurology, Ltd./North Memorial Medical Center
Golden Valley, Minnesota, United States
Hennepin County Medical Center
Minneapolis, Minnesota, United States
University of Minnesota
Minneapolis, Minnesota, United States
Mayo Clinic Rochester
Rochester, Minnesota, United States
St. Cloud Hospital
Saint Cloud, Minnesota, United States
Cox Medical Center
Springfield, Missouri, United States
Mercy Medical Research Institute
Springfield, Missouri, United States
John Cochran VA Medical Center
St Louis, Missouri, United States
Mercy Hospital
St Louis, Missouri, United States
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, United States
Cooper University
Camden, New Jersey, United States
Hackensack University Medical Center
Hackensack, New Jersey, United States
SUNY Buffalo
Buffalo, New York, United States
The Feinstein Institute of Medical Research/Northwell Health
Manhasset, New York, United States
Mount Sinai Hospital New York
New York, New York, United States
Columbia University Medical Center
New York, New York, United States
Weill Cornell Medical College
New York, New York, United States
University of Rochester Medical Center
Rochester, New York, United States
St. Francis Hospital
Roslyn, New York, United States
Stony Brook University
Stony Brook, New York, United States
Crouse Hospital
Syracuse, New York, United States
Duke University Medical Center
Durham, North Carolina, United States
North Carolina Heart & Vascular Research
Raleigh, North Carolina, United States
Coastal Carolina Surgical Associates PA
Wilmington, North Carolina, United States
Novant Health/Forsyth Medical Center
Winston-Salem, North Carolina, United States
Wake Forest University Health Sciences
Winston-Salem, North Carolina, United States
Sanford Health
Fargo, North Dakota, United States
University of Cincinnati Medical Center
Cincinnati, Ohio, United States
Good Samaritan Hospital
Cincinnati, Ohio, United States
Louis Stokes Cleveland VA Medical Center
Cleveland, Ohio, United States
University Hospitals Cleveland Medical Center
Cleveland, Ohio, United States
Ohio State Medical Center
Columbia, Ohio, United States
OhioHealth Research Institute
Columbus, Ohio, United States
Jobst Vascular Institute/University of Toledo
Toledo, Ohio, United States
Mercy Health St. Vincent Medical Center
Toledo, Ohio, United States
St. John Clinical Research Institute
Tulsa, Oklahoma, United States
Providence Brain and Spine Institute
Portland, Oregon, United States
Oregon Health & Science University
Portland, Oregon, United States
Lehigh Valley Hospital - Network Office of Research
Allentown, Pennsylvania, United States
UPMC Altoona
Altoona, Pennsylvania, United States
Doylestown Hospital
Doylestown, Pennsylvania, United States
UPMC Hamot
Erie, Pennsylvania, United States
Penn State Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, United States
UPMC Presbyterian University Hospital
Pittsburgh, Pennsylvania, United States
VA Pittsburgh Healthcare
Pittsburgh, Pennsylvania, United States
Pinnacle Health Cardiovascular Institute
Wormleysburg, Pennsylvania, United States
Lankenau Medical Center
Wynnewood, Pennsylvania, United States
Berks Cardiologists / St. Joseph's Medical Center
Wyomissing, Pennsylvania, United States
The Miriam Hospital
Providence, Rhode Island, United States
Medical University of South Carolina
Charleston, South Carolina, United States
North Central Heart Institute
Sioux Falls, South Dakota, United States
CVA Heart Institute
Kingsport, Tennessee, United States
Tennova Healthcare/ Turkey Creek Medical Center
Knoxville, Tennessee, United States
Baptist Memorial Hospital
Memphis, Tennessee, United States
Vanderbilt University Medical Center
Nashville, Tennessee, United States
Seton Medical Center Austin
Austin, Texas, United States
Cardiothoracic and Vascular Surgeons
Austin, Texas, United States
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Valley Baptist Medical Center
Harlingen, Texas, United States
Houston Methodist Hospital
Houston, Texas, United States
Memorial Hermann Texas Medical Center
Houston, Texas, United States
Intermountain Medical Center
Murray, Utah, United States
University of Utah Hospitals and Clinics
Salt Lake City, Utah, United States
George E. Wahlen Department of Veterans Affairs Medical Center
Salt Lake City, Utah, United States
University of Virginia Health System
Charlottesville, Virginia, United States
Inova Fairfax Health Care
Falls Church, Virginia, United States
Winchester Medical Center
Winchester, Virginia, United States
Overlake Hospital
Bellevue, Washington, United States
University of Washington Medicine-Harborview Medical Center
Seattle, Washington, United States
VA Puget Sound Health Care System
Seattle, Washington, United States
Swedish Medical Center
Seattle, Washington, United States
Providence Sacred Heart Medical Center
Spokane, Washington, United States
West Virginia University
Morgantown, West Virginia, United States
Gundersen Clinic, Ltd
La Crosse, Wisconsin, United States
University of Wisconsin Hospitals & Clinics
Madison, Wisconsin, United States
Fiona Stanley Hospital
Perth, , Australia
Vancouver General Hospital
Vancouver, British Columbia, Canada
Nova Scotia Health Authority
Halifax, Nova Scotia, Canada
St. Michael's Hospital
Toronto, Ontario, Canada
St. Boniface Hospital
Winnipeg, Ontario, Canada
CHU de Québec/ Hôpital de l'Enfant-Jésus
Québec, Quebec, Canada
Soroka University Medical Center
Beersheba, , Israel
Soroka University Vascular Surgery
Beersheba, , Israel
Rambam Healthcare
Haifa, , Israel
Hadassah Medical Center
Jerusalem, , Israel
Shaare-Zedek Medical Center
Jerusalem, , Israel
Rabin Medical Center
Petah Tikva, , Israel
Hospital Clinic Barcelona
Barcelona, , Spain
Countries
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References
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Meschia JF, Lal B, Roubin G, Turan TN, Howard VJ, Benson RT, Carman K, Howard G, Brott TG. Adapting to Evolving Technologies and Treatment Guidelines in a Procedural Trial: A Qualitative Review of the CREST-2 Experience. Neurology. 2023 May 30;100(22):1060-1066. doi: 10.1212/WNL.0000000000207075. Epub 2023 Feb 6.
Kamtchum-Tatuene J, Saba L, Heldner MR, Poorthuis MHF, de Borst GJ, Rundek T, Kakkos SK, Chaturvedi S, Topakian R, Polak JF, Jickling GC; Carotid Atherosclerosis and Stroke Collaboration (CASCO). Interleukin-6 Predicts Carotid Plaque Severity, Vulnerability, and Progression. Circ Res. 2022 Jul 8;131(2):e22-e33. doi: 10.1161/CIRCRESAHA.122.320877. Epub 2022 Jun 17.
Lazar RM, Wadley VG, Myers T, Jones MR, Heck DV, Clark WM, Marshall RS, Howard VJ, Voeks JH, Manly JJ, Moy CS, Chaturvedi S, Meschia JF, Lal BK, Brott TG, Howard G. Baseline Cognitive Impairment in Patients With Asymptomatic Carotid Stenosis in the CREST-2 Trial. Stroke. 2021 Dec;52(12):3855-3863. doi: 10.1161/STROKEAHA.120.032972. Epub 2021 Aug 26.
Haley W, Shawl F, Charles Sternbergh W 3rd, Turan TN, Barrett K, Voeks J, Brott T, Meschia JF. Non-Adherence to Antihypertensive Guidelines in Patients with Asymptomatic Carotid Stenosis. J Stroke Cerebrovasc Dis. 2021 Aug;30(8):105918. doi: 10.1016/j.jstrokecerebrovasdis.2021.105918. Epub 2021 Jun 18.
Turan TN, Meschia JF, Chimowitz MI, Roldan A, LeMatty T, Luke S, Breathitt L, Eiland R, Foley J, Brott TG. Mitigating the effects of COVID-19 pandemic on controlling vascular risk factors among participants in a carotid stenosis trial. J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105362. doi: 10.1016/j.jstrokecerebrovasdis.2020.105362. Epub 2020 Sep 30.
Turan TN, Voeks JH, Chimowitz MI, Roldan A, LeMatty T, Haley W, Lopes-Virella M, Chaturvedi S, Jones M, Heck D, Howard G, Lal BK, Meschia JF, Brott TG. Rationale, Design, and Implementation of Intensive Risk Factor Treatment in the CREST2 Trial. Stroke. 2020 Oct;51(10):2960-2971. doi: 10.1161/STROKEAHA.120.030730. Epub 2020 Sep 21.
Lal BK, Meschia JF, Roubin GS, Jankowitz B, Heck D, Jovin T, White CJ, Rosenfield K, Katzen B, Dabus G, Gray W, Matsumura J, Hopkins LN, Luke S, Sharma J, Voeks JH, Howard G, Brott TG; CREST-2 Investigators. Factors influencing credentialing of interventionists in the CREST-2 trial. J Vasc Surg. 2020 Mar;71(3):854-861. doi: 10.1016/j.jvs.2019.05.035. Epub 2019 Jul 26.
Musialek P, Roubin GS. Commentary: Double-Layer Carotid Stents: From the Clinical Need, through a Stent-in-Stent Strategy, to Effective Plaque Isolation... the Journey Toward Safe Carotid Revascularization Using the Endovascular Route. J Endovasc Ther. 2019 Aug;26(4):572-577. doi: 10.1177/1526602819861546. No abstract available.
Lal BK, Meschia JF, Brott TG. Clinical need, design, and goals for the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis trial. Semin Vasc Surg. 2017 Mar;30(1):2-7. doi: 10.1053/j.semvascsurg.2017.04.004. Epub 2017 Apr 27.
Demaerschalk BM, Brown RD Jr, Roubin GS, Howard VJ, Cesko E, Barrett KM, Longbottom ME, Voeks JH, Chaturvedi S, Brott TG, Lal BK, Meschia JF, Howard G; CREST-2 Investigators. Factors Associated With Time to Site Activation, Randomization, and Enrollment Performance in a Stroke Prevention Trial. Stroke. 2017 Sep;48(9):2511-2518. doi: 10.1161/STROKEAHA.117.016976. Epub 2017 Aug 2.
Howard VJ, Meschia JF, Lal BK, Turan TN, Roubin GS, Brown RD Jr, Voeks JH, Barrett KM, Demaerschalk BM, Huston J 3rd, Lazar RM, Moore WS, Wadley VG, Chaturvedi S, Moy CS, Chimowitz M, Howard G, Brott TG; CREST-2 study investigators. Carotid revascularization and medical management for asymptomatic carotid stenosis: Protocol of the CREST-2 clinical trials. Int J Stroke. 2017 Oct;12(7):770-778. doi: 10.1177/1747493017706238. Epub 2017 May 2.
Provided Documents
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Document Type: Informed Consent Form
Related Links
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CREST-2 Website
Mayo Clinic Clinical Trials
Other Identifiers
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13-004051
Identifier Type: -
Identifier Source: org_study_id
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