Cone Health Physician Contributes to Landmark Stroke Prevention Study in New England Journal of Medicine
The results in the prestigious medical publication help clarify stroke prevention options for some patients.
Greensboro – Results from the landmark CREST-2 clinical trial have been published in the New England Journal of Medicine. Dr. Donald Heck, of Cone Health Neurosurgery in Greensboro, is among the study’s lead authors. Of the 155 hospitals across the United States, Canada and Europe participating in the trial, Heck enrolled the third-highest number of patients and served on the core leadership team overseeing the research.
Cone Health recently recruited Heck and his neurosurgical partner, Dr. Rashid Janjua, to lead the health system’s growing neurovascular surgery program.
Dr. Donald Heck
About Carotid Artery Disease
Carotid arteries are major blood vessels in the neck that supply blood to the brain. When cholesterol plaque builds up in these arteries—a condition known as carotid stenosis—it increases the risk of stroke. Common risk factors include high blood pressure, high cholesterol, diabetes, smoking and a family history of cardiovascular disease.
About the CREST-2 Trial
The CREST-2 (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis) trial compared modern intensive medical therapy alone to medical therapy combined with either carotid stenting or carotid surgery. All participants had severe carotid narrowing but no stroke symptoms at the time of enrollment.
Key Findings
The study found that adding carotid stenting to standard medical treatment reduced the risk of future stroke for selected patients compared with medication alone.
What This Means for Patients
The findings suggest that carotid stenting can further lower stroke risk for some individuals with carotid narrowing. However, treatment decisions remain highly personal. Patients should consult a neurovascular specialist to determine the best approach for their condition.
Cone Health’s Role and Expertise
With the addition of Heck—one of the nation’s foremost experts in cerebrovascular disease—Cone Health has further strengthened its leadership in advanced stroke prevention. The combined expertise of Cone Health Neurosurgery and Vascular Surgery positions the system among the top centers for carotid disease care in North Carolina.
Dr. Heck in His Own Words
“I remember being a resident in 1998 and reading the first reports of carotid stenting. The technology had great potential, but the results were mixed. It’s been an honor to help refine and improve this approach over the years through clinical research. Stroke is such a devastating disease, and seeing our collective efforts lead to a minimally invasive procedure that helps prevent strokes is deeply rewarding.”
