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Updated: Jul 23, 2026

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Carotid Artery Occlusive Disease.
1Division of Vascular Surgery, Department of Surgery, University of Medicine & Dentistry-New Jersey Medical School, 150 Bergen Street, Newark, NJ 07103, USA. hobsonrw@umdnj.edu
Carotid endarterectomy (CEA) is a proven stroke prevention surgery. The Carotid Revascularization Endarterectomy vs Stent Trial (CREST) is comparing CEA to carotid angioplasty and stenting to determine the best treatment for stroke risk reduction.
Area of Science:
- Neurology
- Vascular Surgery
- Cardiovascular Disease
Background:
- Stroke is a leading cause of death and disability in the U.S.
- Current stroke management focuses on risk factors and surgical intervention.
- Carotid endarterectomy (CEA) is the established procedure for mechanical cerebral revascularization.
Purpose of the Study:
- To compare the efficacy and risks of carotid angioplasty and stenting (CAS) versus CEA.
- To evaluate a potential alternative to CEA for stroke prevention.
Main Methods:
- The Carotid Revascularization Endarterectomy vs Stent Trial (CREST) is a clinical trial sponsored by the National Institutes of Health (NIH).
- The trial compares CAS to CEA, building on previous NIH-sponsored trials like NASCET and ACAS.
Main Results:
- Retrospective studies suggest carotid angioplasty and stenting (CAS) is feasible.
- Definitive evidence of clinical effectiveness currently exists only for CEA.
Conclusions:
- The CREST trial is ongoing to determine the comparative effectiveness of CAS and CEA.
- Results will inform optimal treatment strategies for patients at risk of stroke.
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