Carotid endarterectomy 7 carotid stent systems as safe and effective in patients at increased risk of complications for carotid surgery and 1 carotid stent system for patients at average or usual risk of carotid surgery. The SAPPHIRE study of patients at high surgical risk for carotid surgery demonstrated non-inferiority for carotid stenting compared to carotid surgery. The CREST trial, the largest trial comparing carotid surgery to carotid stenting in over 2,500 patients found that carotid artery stenting resulted in a stroke rate of 6.4% versus 4.7% for endarterectomy at 4 years. However, carotid endarterectomy was associated with a slightly higher rate of
Carotid body may involve mitochondrial oxygen sensors and the haem-containing cytochromes that undergo reversible one-electron reduction during oxidative-phosphorylation. Haem reversibly binds O with an affinity similar to that of the carotid body, suggesting that haem containing proteins may have a role in O, potentially this could be one of the complexes involved in oxidative-phosphorylation. This leads to increases in reactive oxygen species and rises in intracellular Ca. However, whether hypoxia leads to an increase or decrease in reactive oxygen species is unknown. The role of reactive oxygen species in hypoxia sensing is also under question. The oxygen dependent enzyme haem-oxidase has also