Marc I. Chimowitz, MBChB, professor of neurology, Countess Alicia Paolozzi SmartState^TM Endowed Chair and associate dean of faculty development at the Medical University of South Carolina, discusses carotid stenosis and the CREST-2 trial.

Dr. Chimowitz has led three consecutive large NIH/NINDS-funded multicenter clinical studies over the past 16 years. These include the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) Trial, the NIH Wingspan Intracranial Stent Registry, and the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial. These trials have led to new standards of treatment for atherosclerotic intracranial arterial stenosis worldwide. The SAMMPRIS study showed that aggressive medical management alone is superior to aggressive medical management combined with a specific type of brain stent for patients at high risk for stroke. Dr. Chimowitz and the team of investigators published the SAMMPRIS results in The New England Journal of Medicine and the Lancet.

The excellent outcomes of patients treated with aggressive medical management in the SAMMPRIS trial led to a successful NINDS application to compare carotid endarterectomy or stenting vs. the SAMMPRIS aggressive medical management regimen in 2480 patients with asymptomatic extracranial carotid stenosis. The CREST 2 trial is being conducted at 120 sites in the United States and Canada, and Dr. Chimowitz is co-directing the Medical Management Coordinating Center for the trial, which is located at MUSC.