Neurology · Sep 3, 2026

Carotid Artery Stenting Is Now an Evidence-Based Adjunct to Intensive Medical Therapy for Stroke Prevention

By Meschia JF

The CREST-2 trial demonstrated that carotid artery stenting combined with intensive medical management (IMM) significantly reduces stroke risk in patients with high-grade asymptomatic carotid stenosis compared with IMM alone. Careful patient selection and operator skill are critical factors for procedural success and can provide real-world validation of stenting as an important adjunct to IMM for stroke prevention. Continued advances in medical management and stenting are expected. It remains vital to engage in shared decision-making when considering moving forward with stenting of asymptomatic carotid stenosis.

doi.org/10.1212/wnl.0000000000218441PubMed 42691470Interventions