March 22, 2010

Landmark clinical trial compares stroke prevention procedures

Results from a study comparing two medical procedures designed to prevent future strokes show both are safe and effective overall. The findings were recently presented at the International Stroke Conference in San Antonio.

One of the largest randomized stroke prevention trials, the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) was conducted at 117 centers in the United States and Canada over nine years, including Emory Heart & Vascular Center.

“This landmark study shows that surgery and stenting are equally safe and effective for people with carotid artery disease,” says Elliot Chaikof, chief of Emory’s Division of Vascular Surgery and Endovascular Therapy.

“This knowledge gives physicians more options to customize treatment for patients at risk for stroke,” adds Chaikof, lead investigator for CREST at Emory.

The clinical trial included 2,502 participants. Carotid endarterectomy (CEA), a surgical procedure to clear blocked blood flow and considered the gold standard prevention treatment, was compared to carotid artery stenting (CAS), a newer and less invasive procedure that involves threading a stent and expanding a small protective device in the artery to widen the blocked area and capture any dislodged plaque.

CREST compared the safety and effectiveness of CEA and CAS in patients with or without a previous stroke. The study was funded by the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

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