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 acid-base transporters (e.g. Na-H) which raise intracellular pH, and activates transporters (e.g. Cl-HCO) which decrease it. Changes in proton concentration caused by acidosis (or the opposite from alkalosis) inside the cell stimulates the same pathways involved in P sensing. Another mechanism is through oxygen sensitive potassium channels. A drop in dissolved oxygen lead to closing of these channels which results in depolarization. This leads to release of the neurotransmitter dopamine in the glossopharyngeal and vagus afferente to the vasomotor area. The type I (glomus) cells in the carotid (and aortic bodies) are derived from neuroectoderm and are thus electrically excitable.