Treating severe carotid artery narrowing to prevent stroke
Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2)
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 ID | NIH-11175454 on NIH RePORTER |
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.
Who could benefit from this research
Good fit: 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.
Not a fit: 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.
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 performed: 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
Jacksonville, United States
- Mayo Clinic Jacksonville — Jacksonville, United States (Active)
Researchers
- Principal investigator: Meschia, James F — Mayo Clinic Jacksonville
- Study coordinator: Meschia, James F
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 below.