Um, Kaitlyn, probably you can add some information why they decided to have these two independent arms, um, in parallel.

Yeah, I think you make some, some good points there, Dr. Reiter.

And I think the reason why this t-trial was initially designed this way was that ACST-2 was already underway when enrolling, when CREST-2 started, and so they didn't need to replicate that study.

And secondly, sort of the big impetus behind CREST-2 was that medical therapy has improved since sort of the historical carotid revascularization trials that we all rely on to inform our practice.

And so the question behind this study was, is medical therapy so much improved that it is now equivalent to carotid revascularization in patients with asymptomatic disease? And so the study was designed in this way not to compare the interventional arms, but really to compare and to focus on the best medical therapy arm versus interventions.

And it was ultimately designed in sort of this two parallel study design, um, I do believe because of power.

And so there was-- if there was a three-way study design, you needed a lot more power in events between the groups in order to get statistical significance.

What's your opinion on the matter?

So did the results of this study end up showing the same thing that the previous two studies or the idea that intervention really reduced risk?

The short answer to that question is kind of, but not really.

And I think it's a little bit nuanced.

So, you know, there were almost 2,500 patients enrolled in this trial.

And to be very clear, and I think it's just important, Jesse said this, but it's important to reiterate, this is really two parallel trials that were not meant to be intertwined.

But the stroke rates in this trial were extraordinarily low.

So, you know, we're talking on the order of like less than 10 in groups.

So it's been pretty interesting.