Carotid endarterectomy open. In several clinical trials, the 30-day incidence of heart attack, stroke, or death was significantly higher with stenting than with endarterectomy (9.6% vs. 3.9%). The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) funded by the National Institutes of Health (NIH) reported that the results of stents and endarterectomy were comparable. However, the European International Carotid Stenting Study (ICSS) found that stents had almost double the rate of complications. The aim of CEA is to prevent the adverse sequelae of carotid artery stenosis secondary to atherosclerotic disease, i.e. ischemic stroke. As with any prophylactic operation, careful evaluation of the relative
Carotid sinus blood vessels. The aortic arch baroreceptors are innervated by the aortic nerve (Nerve of Cyon), which combines with CN X (vagus nerve) and travels to the NTS. It is a sensitive site of the body because stimulation can drive large-scale reflex effects throughout the body. This can be used therapeutically in treatment of resistant hypertension by baroreflex activation. Physical assault at this point, producing massive baroreflex activation can cause dramatic falls in blood pressure and cerebral ischemia. The carotid sinus often has atherosclerotic plaques because of disturbed hemodynamics (low wall shear stress, flow reversal/recirculation). Since these plaques, if large and