Crest-2: Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial
To assess if the proportion of patients with a primary event differs between patients treated with intensive medical management alone compared to CEA, or to CAS, in patients with high grade asymptomatic carotid stenosis. To assess whether intensive medical management differs from CEA and from CAS to maintain the level of cognitive function at 4 years of follow up To assess if there are treatment differences in major stroke, minor stroke, disabling stroke and tissue based stroke at 4 years, using an analytic approach identical to that for the primary aim. To assess if the CEA or CAS versus intensive medical management difference is affected by patient age, sex, severity of carotid stenosis, restenosis, risk factor level and during of the asymptomatic period
Patients with carotid stenosis will undergo either carotid endarterectomy or carotid artery angioplasty. There are 12 follow-up visits spread over four years. Five of the visits include ultrasounds. An MRI is done at the end of year 4. Medications and blood pressure will be checked and questionnaires answered at each visit.
Do you have documented stenosis of your carotid?
Have you had any neurologic symptoms on the same side as your stenosis
No medical history of stroke or TIA on the same side as the stenotic vessel in the previous 180 days
If female, not pregnant
Symptomatic ICH within past 12 months
Ejection fraction < 30%
Do you use an anticoagulant? What medication?