CREST: Stenting versus Surgery for Carotid Artery Stenosis

Colin Derdeyn, leadership committee chair for ISC 2016, interviews Thomas Brott, MD about the results of the CREST trial, which were presented at the meeting in Los Angeles.
2/18/2016 | ISC 2016 | Colin Derdeyn, MD, Thomas Brott, MD

[@pmh1nic]

I had surgery this past Monday to unblock a 90% left carotid artery. The procedure went well with no complications but having had two prior heart attacks I was kept in the hospital overnight. There has been very little discomfort at the incision site with some minor discomfort where the probe was placed in my scalp to monitor brain activity during the procedure. I’ve had two close friends (one older, one younger than me) suffer strokes over the last year. One has been in a nursing home, rehab facility for eight months and unfortunately not making a lot of progress. My other friend still can’t walk without assistance and is constantly dizzy, sometimes severely so. That convinced me not to delay having my procedure. When it comes to something as potentially damaging as strokes procrastination should not be an option. One moment can change your life dramatically in ways that are irreversible and devastating.

[@cookingIsALifestyle-m5c]

@Paul Harris Thanks for sharing. My mom now Dr. recommends her to do this operation or the stent to remove plaque about 90% of it that cause her to have a blockage in right brain and to prevent the second stroke for the next two years. 98% chance of being successful. I still have not decide yet. she is 76. did your

[@olivierplayer1633]

before the surgery control that your blood platelets are on a normal level !!!

[@pmh1nic]

@@olivierplayer1633 My vascular disease is very serious and I’ve been on Plavics and aspirin (both blood thinners) for decades. My cardiologist strongly advised against stopping either prior to the surgery. I got questioned about it by everyone including the surgeon who preferred that I stop taking them prior to the surgery. My cardiologist was adamant in his instructions not to stop taking it and the surgery was done even given the higher risk of bleeding. Fortunately everything went well with no excessive bleeding.

[@hpman2391]

Had surgery last Wed on my left side, now in a month I get the right one done. It was a cake walk. Put me to sleep, stayed over night. Not scared about my next one, never been in the hospital before.

[@qstrian]

I would like to volunteer to become a CREST II study participant.

[@keithkeber5655]

Has the CREST-2 study gotten underway? Are they still accepting patients to take part? (question dated: October 27, 2019) Thank you for this video interview. After release from a neurological ICU, I am due to consult with my primary and a vascular surgeon about surgery for my 100% occlusion (left side). Could someone explain how "symptomatic" and "asymptomatic" patients are differentiated regarding this procedure?

[@robmurnen7082]

I have had two small strokes between April and August 2018. Even though my carotid artery is only about 60% narrowed, the doctors are concerned that the plaque buildup that I have that shows up on CT scans etc. are probably the cause of my strokes as small pieces of the plaque have broken off they think and shot up to my brain causing my strokes. So, I am about to go in for an endarterectomy. The doctor say if I don’tI have about a 30% chance of having another stroke in the next two years and what is even more troubling is that no one knows how big or small the strokes could be. Therefore, I have elected to go in for the operation.

[@HostileButHonourable]

How did your procedure go?

[@Galworld761]

My father had the surgery last week. He was calcified and could not get a stent. There was a complication. They discovered an arterial lining tear. He was in ICU for 4 days. However, once he turned the corner - it was amazing. He was 85% blocked.

[@kevindugan4807]

I believe that is wise.

[@olivierplayer1633]

this is a very dengourous operation , i lost my mother to a endarterectomy !

[@Zgzgzgk]

Bagaimana hasilnya setelah di operasi?

[@westfield90]

I've heard that unless you have over 80% blockage then the risk of stroke by the medical procedure itself is greater.

[@robmurnen7082]

westfield90 However, I have had two small strokes since April and although

[@JohnnyCatFitz]

I've also heard that is why surgery in asymptomatic patients is only done when it gets to over 90-95% blockage.

[@susiQ75]

@@JohnnyCatFitz I have a 50% blockage and I am told 60-70% block age will the Dr do procedure.

[@deeb.9250]

depends also on the kind of plaque... that increases the chance of stroke

[@jakre10]

It all was confusing to me.