Modern Management of Asymptomatic Carotid Stenosis: A Meta-Analysis of CREST-2, SPACE-2, and ECST-2

Field Information Type of Review, Systematic Review with Meta-Analysis Research Question, Does carotid revascularization plus contemporary medical therapy reduce long-term ipsilateral stroke compared to contemporary medical therapy alone in patients with asymptomatic carotid stenosis? PICO Framework Population (P), Patients with asymptomatic carotid stenosis (≥50% by ultrasound or equivalent) Intervention (I), Carotid revascularization (CEA or CAS) plus contemporary medical therapy (high-intensity statins, antiplatelet therapy, blood pressure control) Comparison (C), Contemporary medical therapy alone Outcome (O) Primary: long-term ipsilateral stroke (post-30 days). Secondary: periprocedural complications (30-day stroke, MI, death)