What is your opinion?

So yes, the patient selection is, is a critical issue of CREST, and the question why they decided to lead this totally independent in parallel study arms is not up to mine or I cannot answer.

Probably Kaitlyn has some background information why they decided to, to design the study like that.

It absolutely seems worth mentioning that not only patient selection but also methodology was, um, special in CREST-2, so all patients were treated by a transfemoral access, which is meanwhile certainly not the only standard of care that we have in carotid artery stenting, so we can use a transradial or a direct access like in TCAR.

Um, I'm coming back again to ACST-2, so it's not correct that literature has proven the superiority of endarterectomy above carotid artery stenting amongst asymptomatic patients.

ACST-2 has proven the equivalence, but the necessity was that patients were treatable by both treatment techniques, so ACST-2 randomized an individual either to endarterectomy or to carotid artery stenting, so comparable anatomy, comparable, um, aortic arch, comparable plaque morphology.

And if that was given, the treatment was either way successful and safe.

In your opinion, uh, does the difference in follow-up duration, particularly the slightly shorter follow-up, uh, in the carotid stenting trial, uh, influence, uh, how do you interpret the comparative results?