Treating severe carotid artery narrowing to prevent stroke
Official title: Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2)
Funded at Mayo Clinic Jacksonville · NIH-11175454 · Data updated 2026-11-12
Compares intensive medical therapy alone to adding carotid surgery or stenting for adults with severe carotid artery narrowing who have not had stroke 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) | $302,827 |
| NIH project number | 5U01NS080168-12 |
| Project ID | NIH-11175454 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with significant (typically ≥70%) narrowing of a carotid artery who have not had recent stroke symptoms and who meet the trial's health and safety criteria.
✕Less likely to help
People with recent stroke or transient ischemic attack, only mild carotid narrowing, or who are not candidates for surgery or stenting are unlikely to be eligible or to gain direct benefit from joining.
What this research studies
If you join, you would be randomly assigned to receive either intensive medical treatment alone or intensive medical treatment plus a procedure (carotid endarterectomy or carotid stenting) in one of two parallel trials. Each trial plans about 1,240 participants per comparison and is run at many hospitals, including Mayo Clinic Jacksonville. Doctors will follow people closely after randomization to record any strokes, deaths shortly after procedures, and strokes on the same side as the narrowed artery over time. The goal is to see whether adding a procedure to modern medical care lowers the chance of stroke compared with medicines and lifestyle care alone.
Why it matters
Potential benefit: If successful, this work could clarify whether surgery or stenting adds meaningful stroke protection beyond current intensive medical therapy and help people choose the safest option.
How similar studies have gone: Older trials from the 1980s–1990s showed benefit of revascularization, but improvements in medical therapy since then make this large, modern randomized effort necessary to see if those benefits still apply.
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.
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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.
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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.
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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.
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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.