Carotid artery treatment for people with artery narrowing who don’t have symptoms
Official title: Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2)
Funded at Mayo Clinic Jacksonville · NIH-11595509 · Data updated 2026-11-12
A large, international study is testing whether intensive medical care plus either carotid surgery or carotid stenting improves outcomes for people with high-grade carotid artery narrowing who have not yet had symptoms.
Quick facts
| Grant type | U01 cooperative agreement |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Mayo Clinic Jacksonville NIH-funded |
| Lab location | 1 site (Jacksonville, United States) |
| Project start | March 15, 2014 |
| Project end | August 31, 2027 |
| Funding year | 2026 |
| Award (this year) | $118,123 |
| NIH project number | 3U01NS080168-12S2 |
| Project ID | NIH-11595509 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with asymptomatic high-grade carotid artery stenosis who meet trial criteria and consent to participation.
✕Less likely to help
Some participants may not experience a reduced stroke risk and may undergo procedures with risks without added benefit.
What this research studies
CREST-2 is enrolling patients across many sites to see if adding surgical removal of the narrowed carotid artery or a stent to intensive medical care reduces strokes compared with intensive medical care alone. The study uses two parallel randomized trials to compare each procedure plus IMM against IMM alone. It is coordinated by Mayo Clinic Jacksonville with data analysis support from the University of Alabama at Birmingham, and it adheres to FDA and regulatory standards.
Why it matters
Potential benefit: If successful, the approach could lower stroke risk for people with asymptomatic carotid stenosis through clearer guidance on when procedures add benefit beyond medical management.
How similar studies have gone: Past trials have informed management strategies, but CREST-2 specifically tests the added value of procedures alongside intensive medical care for asymptomatic patients.
Where this research is happening
-
Mayo Clinic Jacksonville
Jacksonville, United States Active
Researchers
- Principal investigator: Meschia, James F — Mayo Clinic Jacksonville
- Study coordinator: Meschia, James F
Related research
Other NIH-funded projects on the same topics.
-
Using genes to find new risk factors and treatments for carotid artery disease
Researchers are using big genetic data to uncover why carotid artery disease occurs and to find new ways to prevent and treat it for people at risk.
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Surgery, stenting, or medicine for people with severe carotid artery narrowing who have no symptoms
This project compares adding carotid surgery or artery stents to intensive medical treatment versus intensive medical treatment alone for people with severe narrowing of the carotid artery who have not had symptoms.
-
Treating severe carotid artery narrowing to prevent stroke
Compares intensive medical therapy alone to adding carotid surgery or stenting for adults with severe carotid artery narrowing who have not had stroke symptoms.
-
Finding genetic causes and treatment targets for carotid artery narrowing
This project uses veterans' genetic data and medical records to find why carotid arteries narrow and help people at risk of stroke.
-
Improving balance and mobility in older adults with carotid artery narrowing through exercise.
This study is looking at how a special 12-week exercise program can help older adults with mild carotid artery narrowing improve their balance and mobility, so they can stay active and prevent falls.
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Identifying new risk factors and treatments for carotid artery narrowing
This study is looking into how our genes might affect carotid stenosis, a condition that can increase the risk of strokes, to help find better ways to prevent and treat it for people with heart-related issues.
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.