Carotid stenting stenosis of the internal carotid artery. Carotid stenting may be considered an alternative to carotid surgery in average surgical risk patients, albeit with a higher risk of death or stroke as seen in the SAPPHIRE and CREST trials. Features that favor carotid stenting include non-atherosclerotic cause of the stenosis (fibrodysplasia, radiation, early post-surgical stenosis or flap) an experienced center and experienced physician performing the procedure. Features that make stent placement more difficult include significant aortic arch tortuosity, thrombus containing lesions, occluded carotid artery, heavily calcified vessels, symptomatic patients and very tortuous and twisting vessels. None of these affect open, surgical
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