About this episode

The episode discusses the evolution of treatment for asymptomatic carotid artery stenosis through pivotal clinical trials and recent advancements in medical therapy.

Welcome back to the Audible Bleeding series: Landmark Papers in Vascular Surgery. In this episode, co-hosts John and Dr. Jesse Columbo are joined by our guest, Dr. Caitlin Hicks, to discuss one of the most studied—and most debated—topics in vascular surgery: asymptomatic carotid stenosis. In this episode, we'll trace that evolution through three pivotal trials: ACAS and ACST-1, which established carotid endarterectomy as the standard of care; and the newly published CREST-2, which challenges us to reconsider everything we thought we knew. Along the way, we'll explore how advances in statin therapy, blood pressure control, and antiplatelet agents have fundamentally changed the natural history of this disease—and what that means for our patients today." Links to Landmark Papers: (ACAS) Endarterectomy for Asymptomatic Carotid Artery Stenosis (ACST-1) 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis: a multicentre randomised trial (CREST-2) Medical Management and Revascularization for Asymptomatic Carotid Stenosis Guests: Dr. Caitlin Hicks, MD ( @CaitlinWHicks ); Associate Fellowship Program Director, Vascular Surgery & Endovascular Therapy…

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