Evidence map›Paper›PMID 28446652›Full record

ArticleNeurology2017

Asymptomatic carotid stenosis: Medicine alone or combined with carotid revascularization.

Donald V Heck, Gary S Roubin, Kenneth G Rosenfield, William A Gray, Christopher J White, Tudor G Jovin, Jon S Matsumura, Brajesh K Lal, Barry T Katzen, Guilherme Dabus and 2 more

Abstract read
In one paragraph

Article in Neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 1 country.

Donald V HeckFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL. dvheck66@gmail.com.
Gary S RoubinFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Kenneth G RosenfieldFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
William A GrayFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Christopher J WhiteFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Tudor G JovinFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Jon S MatsumuraFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Brajesh K LalFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Barry T KatzenFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Guilherme DabusFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Brian T JankowitzFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Thomas G BrottFrom the Novant Health Forsyth Comprehensive Stroke Center (D.V.H.), Winston Salem, NC; Cardiovascular Associates of the Southeast (G.S.R.), Birmingham, AL; Massachusetts General Hospital (K.G.R.), Boston; Main Line Health System/Lankenau Heart Institute (W.A.G.), Wynnewood, PA; Ochsner Medical Institutions (C.J.W.), New Orleans, LA; University of Pittsburgh Medical Center (T.G.J., B.T.J.), PA; University of Wisconsin School of Medicine and Public Health (J.S.M.), Madison; University of Maryland Medical Center (B.K.L.), Baltimore, MD; Miami Cardiac and Vascular Institute (B.T.K., G.D.); and Mayo Clinic (T.G.B.), Jacksonville, FL.
Ochsner Medical Center · USUniversity of Wisconsin–Madison · USCardiovascular Research Associates · USLankenau Heart Institute · USMain Line Health · USMassachusetts General Hospital · USThe Cardiac and Vascular Institute · USUniversity of Maryland Medical Center · US

Funding

CREST-2 Clinical Coordinating CenterU01NS080168 · NINDS · MAYO CLINIC JACKSONVILLE · PI Thomas G Brott, JAMES F MESCHIA · 2014 to 2026
$56.3M
NINDS NIH HHS U01 NS080168
6 · The paper itself

Abstract

Two positive randomized trials established carotid endarterectomy (CEA) as a superior treatment to medical management alone for the treatment of asymptomatic carotid artery stenosis. However, advances in medical therapy have led to an active and spirited debate about the best treatment for asymptomatic carotid stenosis. The Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis (CREST 2) trial aims to better define the best treatment for the average patient with severe asymptomatic carotid stenosis. Enrollment in the trial may be hampered by strong opinions on either side of the debate. It is important to realize that equipoise exists and that neither the old data on CEA nor the new data on optimal medical therapy provide a rigorous answer. The assumption that medical therapy has already been proven superior to revascularization procedures may hinder both enrollment in the trial and technical advancements in revascularization procedures.

Indexed as

Endarterectomy, CarotidStentsAsymptomatic DiseasesCarotid StenosisHumansRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID28446652
PMCPMC5440242
OpenAlexW2608005734

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.