Trial reportCirculation2012
Stroke after carotid stenting and endarterectomy in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST).
Trial report in Circulation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00004732 (Carotid Revascularization Endarterectomy Versus Stenting Trial), which is not on this map. Cited by 44 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST)
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- One-Year Outcomes of CGuard Double Mesh Stent in Carotid Artery Disease: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Guidelines for the use of cerebral oximetry by near-infrared spectroscopy in cardiovascular anesthesia: a report by the cerebrospinal Division of the Academic Committee of the Japanese Society of Cardiovascular Anesthesiologists (JSCVA).Journal of anesthesia · 2019Guideline
- Meta- analysis and meta-regression analysis of the associations between sex and the operative outcomes of carotid endarterectomy.BMC cardiovascular disorders · 2015Pooled it
- Periprocedural Stroke and Myocardial Infarction as Risks for Long-Term Mortality in CREST.Circulation. Cardiovascular quality and outcomes · 2018Trial
- Long-Term Results of Stenting versus Endarterectomy for Carotid-Artery Stenosis.The New England journal of medicine · 2016 · on this mapTrial
- Clinical Outcomes of 5000 IU Heparin Versus Activated Clotting Time-Guided Heparinization During Noncardiac Arterial Procedures: A Propensity Score Matched Analysis.Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2026Article
- Carotid Artery Stenting Outcomes in Comprehensive Stroke Hospitals (CASSH): A Prospective Multicenter Study.Stroke (Hoboken, N.J.) · 2026Article
- Clinical outcomes of carotid artery stenting with open- versus closed-cell stents.Journal of neurointerventional surgery · 2026Article
- Carotid artery stenting with open vs closed stent cell configurations in the CREST-2 Registry.Journal of vascular surgery · 2025Article
- What the National Coverage Determination for Carotid Artery Stenting Means for the Treatment of Patients with Carotid Artery Disease.Annals of vascular surgery · 2025Review
- [Stenting of the extracranial internal carotid artery].Innere Medizin (Heidelberg, Germany) · 2025Review
- Carotid Artery Stenting Outcomes by Neurointerventional Surgeons (CASONI).Stroke (Hoboken, N.J.) · 2025Article
- CASSH Registry: Rationale and Study Design.Stroke (Hoboken, N.J.) · 2024Article
- Comparative on the effectiveness and safety of different carotid endarterectomy techniques: a single-center Retrospective Study.Journal of cardiothoracic surgery · 2024Article
- Delayed Migration of Tapered Open-Cell Design Carotid Stent: A Case Report.Neurointervention · 2023Article
- Carotid artery interventions - endarterectomy versus stenting.AsiaIntervention · 2023Review
- Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade.Healthcare (Basel, Switzerland) · 2022Article
- Clinical Outcomes of Second- versus First-Generation Carotid Stents: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Review
- Caloric restriction overcomes pre-diabetes and hypertension induced by a high fat diet and renal artery stenosis.Molecular biology reports · 2022Article
- The effect of systemic factors on retinal blood flow in patients with carotid stenosis: an optical coherence tomography angiography study.GeroScience · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
backgroundStroke occurs more commonly after carotid artery stenting than after carotid endarterectomy. Details regarding stroke type, severity, and characteristics have not been reported previously. We describe the strokes that have occurred in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). METHODS AND
resultsCREST is a randomized, open-allocation, controlled trial with blinded end-point adjudication. Stroke was a component of the primary composite outcome. Patients who received their assigned treatment within 30 days of randomization were included. Stroke was adjudicated by a panel of board-certified vascular neurologists with secondary central review of clinically obtained brain images. Stroke type, laterality, timing, and outcome were reported. A periprocedural stroke occurred among 81 of the 2502 patients randomized and among 69 of the 2272 in the present analysis. Strokes were predominantly minor (81%, n=56), ischemic (90%, n=62), in the anterior circulation (94%, n=65), and ipsilateral to the treated artery (88%, n=61). There were 7 hemorrhages, which occurred 3 to 21 days after the procedure, and 5 were fatal. Major stroke occurred in 13 (0.6%) of the 2272 patients. The estimated 4-year mortality after stroke was 21.1% compared with 11.6% for those without stroke. The adjusted risk of death at 4 years was higher after periprocedural stroke (hazard ratio, 2.78; 95% confidence interval, 1.63-4.76).
conclusionsStroke, particularly severe stroke, was uncommon after carotid intervention in CREST, but stroke was associated with significant morbidity and was independently associated with a nearly 3-fold increased future mortality. The delayed timing of major and hemorrhagic stroke after revascularization suggests that these strokes may be preventable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.