Several industry-supported registries have reported peri- procedural complication rates of 2.1% to 8.3%.534 The lack of medically treated control groups makes the results of these registries difficult to interpret. CREST enrolled both symptomatic and asymptomatic patients with carotid stenosis who could technically undergo either CEA or CAS.535 Asymptomatic patients could be included if they had a stenosis of 60% on angiography, 70% on ultrasonography, or 80% on computed tomographic angi- ography or MRA if the stenosis on ultrasonography was 50% to 69%. Randomization was stratified according to symptom status. The primary end point was a composite of stroke, MI, or death resulting from any cause during the periprocedural period or any ipsilateral stroke within 4 years after random- ization. There was no difference in the estimated 4-year occurrence of the composite primary end point between stent- 0.81 1.51; P=0.51), with no significant heterogeneity based on symptom status. CREST demonstrated an interaction of age on the primary end point, with age >70 years showing a significant benefit for CEA over CAS. CAS had a higher periprocedural stroke/death rate for patients >64 years of Patient age may be among the factors to consider when choosing between the 2 procedures. The periprocedural rate of stroke was higher with CAS than with CEA (4.1% versus 2.3%; P=0.01), and the periprocedural rate of MI was lower with CAS than with CEA (1.1% versus 2.3%; P=0.03). In the periprocedural period, point estimates for the rates of any stroke or death among asymptomatic patients were low (2.5% in CAS versus 1.4% for CEA; HR, 1.88; 95% CI, 0.79 4.42; P=0.15). 