Surgery, stenting, or medicine for people with severe carotid artery narrowing who have no symptoms
Official title: Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2)
Funded at Mayo Clinic Jacksonville · NIH-11193054 · Data updated 2026-11-12
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.
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, 2026 |
| Funding year | 2025 |
| Award (this year) | $156,497 |
| NIH project number | 3U01NS080168-12S1 |
| Project ID | NIH-11193054 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with high-grade (severe) asymptomatic carotid artery narrowing who meet surgical and medical eligibility criteria are the ideal candidates.
✕Less likely to help
People with symptomatic carotid disease, low-grade narrowing, or who are not candidates for surgery or stenting would not be expected to benefit directly from this project.
What this research studies
If you have severe narrowing of a carotid artery but no recent stroke or warning symptoms, this project randomly assigns people to get intensive medical care alone or to get intensive medical care plus either carotid surgery or carotid stenting. Participants are followed over time for stroke, complications, and overall health. The work runs in parallel: one arm compares surgery plus medicine to medicine alone and the other compares stenting plus medicine to medicine alone. The trial has enrolled thousands of patients at many U.S. and international sites and used a mix of on-site and remote monitoring, especially during the COVID-19 period.
Why it matters
Potential benefit: If successful, the results could clarify which approach best prevents stroke and help people avoid unnecessary procedures.
How similar studies have gone: Earlier trials, including the original CREST trial, compared stenting and surgery and informed safety and outcomes, but CREST-2 is testing whether adding revascularization to modern intensive medical care provides extra stroke prevention.
Where this research is happening
-
Mayo Clinic Jacksonville
Jacksonville, United States Active
Researchers
- Principal investigator: Brott, Thomas G — Mayo Clinic Jacksonville
- Study coordinator: Brott, Thomas G
Related research
Other NIH-funded projects on the same topics.
-
Carotid artery treatment for people with artery narrowing who don’t have symptoms
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.
-
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.
-
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.
-
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.