Carotid endarterectomy benefits and risks of the procedure is required on an individual patient basis. Peri-operative CEA risks for combined 30 day mortality and stroke risk should be < 3% for asymptomatic patients and ≤ 6% for symptomatic patients. Symptomatic patients typically have either transient ischemic attack (TIA) or minor stroke, defined as a focal neurologic defect affecting one side of the body, speech, or vision. Asymptomatic patients have narrowing of their carotid arteries, but have not experienced a TIA or stroke. Carotid stenosis is diagnosed with ultrasound doppler studies of the neck arteries, magnetic resonance angiography (MRA) or computed tomography angiography
Carotid sinus with verapamil or adenosine though is still the preferred first line of treatment in a hemodynamically stable patient Carotid sinus reflex death is a potential etiology of sudden death in which manual stimulation of the carotid sinus allegedly causes strong glossopharyngeal nerve (Vagus nerve is for aortic arch baroreceptors) impulses leading to terminal cardiac arrest. Carotid sinus reflex death has been pointed out as a possible cause of death in cases of strangulation, hanging and autoerotic strangulation, but such deductions remain controversial. However, medical literature is replete with studies examining the use of carotid sinus massage as a diagnostic and