Carotid stenting dilation and cerebral angiography. Carotid stenting is the preferred therapy for patients who are at an increased risk with carotid surgery. High risk factors include medical comorbidities (severe heart disease, heart failure, severe lung disease, age > 75/80, etc.) and anatomic features (contralateral carotid occlusion, radiation therapy to the neck, prior ipsilateral carotid artery surgery, intra-thoracic or intracranial carotid disease) that make surgery difficult or risky. Anatomic high surgical risk: Co-morbid high surgical risk: Using the criteria of successful trials, candidates are either symptomatic (TIA or stroke) patients with >50% stenosis of the carotid artery, or are asymptomatic with >80%
Middle cerebral artery Middle cerebral artery The middle cerebral artery (MCA) is one of the three major paired arteries that supply blood to the cerebrum. The MCA arises from the internal carotid and continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex. It also supplies blood to the anterior temporal lobes and the insular cortices. The left and right MCAs rise from trifurcations of the internal carotid arteries and thus are connected to the anterior cerebral arteries and the posterior communicating arteries, which connect to the posterior cerebral arteries. The MCAs are not