Stenting and Surgery Equally Safe and Effective at Lowering Long-Term Risk of Stroke, Study Finds

Stenting and surgery are equally effective at lowering the long-term risk of stroke from a narrowed carotid artery, according to results of the CREST trial that were recently published in the New England Journal of Medicine. Miami Cardiac & Vascular Institute was one of the key clinical trial sites in the United States to participate in the study – one of the largest randomized stroke prevention trials ever, in both patients who had stroke symptoms and those who hadn’t but were at risk from carotid artery narrowing.

CREST (Carotid Revascularization Endarterectomy versus Stenting Trial) conducted a study of 2,502 patients with an average age of 69 for up to 10 years at 117 centers in the U.S. and Canada. The study found the risk for stroke after either stenting or surgery (endarterectomy) was about 7 percent. The 10-year comparisons of restenosis (re-narrowing of the carotid artery) were low for both stenting and surgery – about 1 percent per year. Equal benefit was found for older and younger individuals, men and women, patients who had previously had a stroke, and those who had not.

“These long-term results of a landmark clinical trial mean that patients and physicians have a choice and the ability to optimize which treatment might be suitable for individual patients,” said Barry T. Katzen, M.D., founder and chief medical executive of Miami Cardiac & Vascular Institute, and the site principal investigator. Dr. Katzen is also a member of the CREST Interventional Management Committee.

Stroke is the fifth most common cause of death in the United States and the leading cause of disability in adults. Plaque buildup can cause narrowing and hardening of the carotid artery. This can reduce blood flow and cause clotting, which can result in a stroke. Endarterectomy is a surgical procedure performed to remove the narrowed segment of the artery, while stenting is an interventional procedure that uses a catheter to place a stent in the narrowed artery to widen it.

Despite the results of CREST, research continues to find the best way to manage stroke risk. CREST-2 was launched in December 2014 to compare stenting and surgery to medical management. Dr. Katzen also leads the interventional team at Miami Cardiac & Vascular Institute for the CREST-2 trial, which is supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health.

Miami Cardiac & Vascular Institute is part of Baptist Health South Florida, the largest faith-based, not-for-profit healthcare organization in the region. It also includes Baptist Hospital, Baptist Children’s Hospital, South Miami Hospital, Doctors Hospital, West Kendall Baptist Hospital, Homestead Hospital, Mariners Hospital and Baptist Outpatient Services. For more information, visit BaptistHealth.net/Heart and connect with BaptistHealthSF on Facebook, Twitter and YouTube.

Contact: Claudia Vigil-Perez, [email protected], 786-596-4507