Carotid stenting dilation and cerebral angiography. Carotid stenting is the preferred therapy for patients who are at an increased risk with carotid surgery. High risk factors include medical comorbidities (severe heart disease, heart failure, severe lung disease, age > 75/80, etc.) and anatomic features (contralateral carotid occlusion, radiation therapy to the neck, prior ipsilateral carotid artery surgery, intra-thoracic or intracranial carotid disease) that make surgery difficult or risky. Anatomic high surgical risk: Co-morbid high surgical risk: Using the criteria of successful trials, candidates are either symptomatic (TIA or stroke) patients with >50% stenosis of the carotid artery, or are asymptomatic with >80%
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