How do the results of CREST-2 influence your recommendations on screening for asymptomatic carotid stenosis?

Agree with the prior comment. One important nuance is what “medical management” actually meant in CREST-2. This was centralized, protocol-driven care with structured lifestyle counseling and medication escalation, including access to PCSK9 inhibitors with costs covered. Even in that highly organized...

The CREST-2 trial provides important information about the management of patients with high-grade asymptomatic carotid stenosis. It demonstrated that carotid stenting was significantly better than intensive medical management in preventing a stroke. I will consider carotid stenting for many such pat...