Carotid artery treatment and medical care for preventing cognitive decline in asymptomatic patients with high-grade carotid narrowing (CREST-H)
Official title: Carotid Revascularization and Medical Management for Asymptomatic CarotidStenosis Trial - Hemodynamics (CREST-H)
Funded at Columbia University Health Sciences · NIH-11374122 · Data updated 2026-11-12
This project tests whether fixing narrowed carotid arteries or using medical management can keep brains healthier and protect thinking skills in people without stroke symptoms but with severe carotid blockage.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Columbia University Health Sciences NIH-funded |
| Lab location | 1 site (New York, United States) |
| Project start | May 15, 2017 |
| Project end | July 31, 2027 |
| Funding year | 2026 |
| Award (this year) | $626,863 |
| NIH project number | 5R01NS097876-10 |
| Project ID | NIH-11374122 on NIH RePORTER |
Who could benefit from this research
✓Could help
Ideal candidates are adults with asymptomatic, high-grade carotid stenosis and evidence of cerebral hemodynamic impairment.
✕Less likely to help
Patients without significant hemodynamic impairment or those unlikely to be offered revascularization may see limited or no cognitive benefit.
What this research studies
CREST-H focuses on patients with high-grade carotid stenosis who haven’t had a stroke but may have reduced brain blood flow and cognitive changes. The study is coordinated with the larger CREST-2 trials and uses MRI or CT perfusion imaging to measure brain blood flow and determine if revascularization plus intensive medical management can stabilize or improve thinking abilities. Enrollment is nearing its revised target, following delays from the pandemic, and aims to provide clear answers about the cognitive impact of carotid treatment strategies. Participants receive either carotid endarterectomy or stenting plus IMM or IMM alone, with imaging and follow-up to track brain health and clinical outcomes.
Why it matters
Potential benefit: If successful, the findings could guide treatment choices to protect cognition in people with severe carotid narrowing.
How similar studies have gone: Prior evidence links hemodynamic impairment to cognitive changes, but this trial is among the first randomized tests of revascularization for cognitive outcomes in this population.
Where this research is happening
-
Columbia University Health Sciences
New York, United States Active
Researchers
- Principal investigator: Marshall, Randolph S — Columbia University Health Sciences
- Study coordinator: Marshall, Randolph S
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About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.