Carotid artery disease, also called carotid artery stenosis, occurs when the arteries in the neck are narrowed or blocked by a buildup of plaque, which can lead to stroke. The CREST-2 study is designed to compare three different methods of stroke prevention to find the safest and most effective treatment.
The CREST-2 study will compare two surgical procedures that reopen the carotid artery in the neck (called revascularization), to intensive medical management with drugs and lifestyle modification in patients without recent stroke and without stroke warning signs. The information from this study will help us learn the best way to prevent strokes in other people.
The two procedures available in this trial are carotid endarterectomy and carotid stenting. A carotid endarterectomy involves making an incision in the neck and removing the plaque that causes the narrowing. Carotid stenting involves inserting a catheter in the artery below the fold at the top of your leg. A stent (mesh-like metal device) is placed in the narrowed part of the carotid artery to hold it open.
The study will compare intensive medical management alone, to intensive medical management in combination with carotid endarterectomy, to intensive medical management combined with carotid stenting. All study participants will receive intensive medical management to help control their risk factors for stroke.
Ideal candidates for the study are people who have narrowing of their carotid artery, without stroke warning signs caused by that artery such as mini-strokes, temporary strokes called TIAs, temporary paralysis or numbness on one side of the body, temporary slurring of speech, or other temporary brain symptoms. They are looking for men and women, 35 years or older, with a narrowing (70 percent or greater) of at least one of their carotid arteries and no other serious medical complications.
The study is open and we are currently looking for candidates. If you are interested in signing up or want more information, call the LeBauer Cardiovascular Research Foundation at (336) 832-3799 or visit http://www.crest2trial.org.
Dr. Jonathan Berry is an interventional cardiologist at CHMG HeartCare and the cardiovascular section chief and medical director of the peripheral vascular lab at Cone Health. Dr. Berry is a 1983 graduate of University of Pennsylvania School of Medicine, completing his residency in internal medicine at Duke University Medical Center. He specializes in interventional cardiology and peripheral vascular disease, completing fellowships at both Duke University Medical Center and University of Michigan Hospitals. Dr. Berry also serves as a clinical professor at UNC-Chapel Hill School of Medicine.
Dr. Wells Brabham is a vascular surgeon and member of the Cone Health Medical Group. Dr. Brabham is a 2001 graduate of Medical University of South Carolina. He completed his residency in general surgery and his fellowship in vascular surgery at University of North Carolina-Chapel Hill.