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NEJM Clinician recently summarized results of the CREST-2 randomized trials on treating patients with asymptomatic carotid stenosis. Patients who underwent stenting plus medical management had lower 4-year risk for stroke than those who received medical management alone (2.8% vs. 6%; P=0.02), whereas a small difference between endarterectomy and medical management alone didn’t reach significance (3.7% and 5.3%). Experts are starting to weigh in on the trial’s implications; here we summarize two new commentaries.
Marc Chimowitz, a neurologist, makes the following points:
Periprocedural myocardial infarction and hemorrhage weren’t included as primary outcomes in CREST-2. Including them might have tipped statistical significance above the…