CREST trial called 'seminal and robust'
The CREST trial that compared traditional surgery with less-invasive stenting to clear dangerously clogged carotid arteries in the neck is being called "seminal and robust."
The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) found that the safety and efficacy of both procedures are roughly equal. The trial, conducted throughout the United States and Canada, is one of the largest randomized stroke prevention trials ever.
Loyola University Medical Center is among the centers that participated in CREST.
"Our multidisciplinary team enrolled patients in both arms of this seminal and robust trial," said Dr. Jos- Biller, one of the principal investigators at Loyola. "The data obtained at Loyola and other centers now will better inform doctors and patients about the relative benefits and risks of endarterectomy and stenting." Biller is chairman of the Department of Neurology at Loyola University Chicago Stritch School of Medicine. The other principal investigator at Loyola is Dr. Fred Leya, director of the cardiac catheterization lab.
Results were announced Feb. 26 at the 2010 International Stroke Conference in San Antonio. The study was funded by the National Institute of Neurological Disorders and Stroke and led by researchers at the Mayo Clinic in Jacksonville, Fla and the University of Medicine and Dentistry of New Jersey in Newark.
Carotid arteries on each side of the neck supply blood to the brain. As a patient ages, plaque can build up, causing the artery to stiffen and narrow. A patient can suffer a stroke if the artery becomes completely blocked. Or, bits of plaque can break off and travel to the brain and cause a mini stroke called a transient ischemic attack (TIA).
The traditional gold standard treatment is an endartectomy. A surgeon peels out the plaque deposit by removing the inner lining of the clogged artery. In the newer stenting procedure, a surgeon uses a catheter to deploy a stent (mesh tube). The stent expands inside the artery to increase blood flow.