CREST-2: Carotid Revascularization Did Not Improve Cognition Over 4 Years

Prespecified cognitive secondary analyses from the CREST-2 trials evaluated whether carotid stenting or endarterectomy, added to intensive medical management, improved cognition in patients with asymptomatic carotid stenosis of 70% or greater. Among 2,165 participants assessed with five cognitive tests over up to 4 years, the trials reported no significant between-group differences in composite z scores or any individual test comparing revascularization plus medical management to medical management alone. The authors concluded that neither carotid stenting nor endarterectomy significantly improved cognitive function compared with intensive medical management alone.

Most relevant for: Patients with severe asymptomatic carotid artery stenosis being considered for carotid stenting or endarterectomy.

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