Morton Plant Hospital to Participate in Stroke Trial

January 22, 2016

Intense Medical Management vs. Surgery

CLEARWATER, Fla., (January 22, 2016) -- Morton Plant Hospital is one of 120 medical centers across the United States and Canada and one of four in Florida participating in a clinical trial to determine the best way to prevent strokes in people who have a high amount of blockage in their carotid artery but no stroke symptoms related to that blockage.

The Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Study or CREST-2 will compare three different methods of stroke prevention to find the safest and most effective treatment for patients with narrowing of their carotid arteries. 

The three treatment methods in CREST-2 are:

  • Intensive medical management
  • Intensive medical management and a carotid endarterectomy (CEA), a surgical procedure that removes plaque buildup in the carotid artery in the neck
  • Intensive medical management and carotid artery stenting (CAS), a surgical procedure to place a stent inside the vessel to push the walls open so blood can flow unobstructed.
Working with the patient, doctors will decide which of the two surgical procedures is best for the patient and then each patient will randomly be treated with medical management alone or medical management plus the selected surgical procedure.

To help control their risk factors, all study participants will receive intensive medical management. This will involve a lifestyle intervention to monitor and manage risk factors such as blood pressure, cholesterol, smoking cessation, weight loss and physical activity.

“The critical question of this study is whether intense medical management makes surgical procedures unnecessary in patients with carotid atherosclerosis but no stroke symptoms,” said Eric Lopez del Valle, MD, interventional neuroradiologist.

Cognitive testing is another piece of the CREST-2 trial. Participants will have cognitive testing at baseline, 1 month and every 12 months up to 48 months to determine if cognitive outcomes are different among the treatment groups.

“Cognitive testing will help determine if one treatment plan is superior in not only preventing overt strokes but also prevent small strokes that could cause cognitive impairment,” said Neurologist Ajay Arora, MD.

Morton Plant Hospital also was one of 117 medical centers that participated in the CREST study, a 9-year trial that compared carotid endarterectomy and carotid artery stenting in both symptomatic and asymptomatic patients.

CREST-2 will build on this effort to see if medical management alone is effective for asymptomatic patients.

“Preventing strokes involves managing and treating risk factors. The CREST trial showed that CEA and CAS were both viable ways to do this,” said Vascular Surgeon Yves Gabriel, MD. “CREST-2 will help us determine if we can manage these risk factors without surgery.”

To be considered for CREST-2, patients must be at least 35 years old and have carotid stenosis that is treatable by CEA or CAS. They must not have had a stroke or any symptoms of stroke within the past 180 days. Other criteria also apply.

About Morton Plant Hospital
For nearly a century, Morton Plant Hospital has been committed to improving the health of all we serve through community-owned health care services that set the standard for high-quality, compassionate care. Our 687-bed hospital is proud to offer nationally recognized care delivered in more than 50 specialty areas. Morton Plant Hospital offers innovative, accessible, and quality services to provide our community with a lifetime of compassionate, convenient care. For more information, call (727) 953-6877, or visit us on Facebook or at 300 Pinellas St., Clearwater, Fla.

About BayCare Health System
BayCare is a leading not-for-profit health care system that connects individuals and families to a wide range of services at 14 hospitals and hundreds of other convenient locations throughout the Tampa Bay and central Florida regions. Inpatient and outpatient services include acute care, primary care, imaging, laboratory, behavioral health, home care, and wellness. Our mission is to improve the health of all we serve through community-owned, health care services that set the standard for high-quality, compassionate care. For more information, visit BayCare on the Web at