CV section members discuss CREST Trial results as Los Angeles Section Meeting

The CREST trial remains a hot topic among practitioners of carotid surgery and stenting and was reviewed at a special session at the Joint Section meeting.  The final study results were published last spring in the New England Journal of Medicine.

CREST was the largest prospective randomized trial to date comparing carotid endarterectomy and carotid artery stenting , enrolling 2502 patients from 117 US and Canadian centers.

For the composite primary endpoint of any stroke, myocardial infarction (MI), or death during the periprocedural period or ipsilateral stroke on follow-up, stenting was associated with a 7.2% rate of these events vs 6.8% with surgery, a nonsignificant difference.

At 30 days, the rate of stroke was significantly higher with stenting at 4.1%, vs 2.3% with surgery, although major stroke was not different at less than 1% in both groups.

Conversely, MI was higher with CEA at 2.3% vs 1.1% with stenting, again a statistical difference. Patients who had an MI, though, reported a better quality of life after recovery than those who had a stroke, the study authors noted.