Internal carotid artery is known as the carotid sinus or the carotid bulb. The ascending portion of the cervical segment occurs distal to the bulb, when the vessel walls are again parallel. The internal carotid runs vertically upward in the carotid sheath and enters the skull through the carotid canal. During this part of its course, it lies in front of the transverse processes of the upper three cervical vertebrae. It is relatively superficial at its start, where it is contained in the carotid triangle of the neck, and lies behind and medial to the external carotid, overlapped by the sternocleidomastoid muscle, and
Carotid stenting trial. This trial showed no difference between carotid stenting and carotid surgery in average risk patients. Most recently, a broad consensus of experts released a guideline document suggesting that in most cases, carotid stenting may be considered an alternative therapy to surgery. Carotid stenting can be performed under general or local anesthesia. Critical steps in the procedure are vascular access, crossing the stenosis with a wire, deploying a stent across the lesion, and removing the vascular access. A number of other steps may or may not be performed, including the use of a cerebral protection device, pre- or post-stent balloon