Common carotid artery deep cervical artery and the descending branch of the occipital artery; the vertebral artery takes the place of the internal carotid artery within the cranium. The right common carotid may rise above the level of the upper border of the sternoclavicular joint; this variation occurs in about 12 percent of cases. In other cases, the artery on the right side may arise as a separate branch from the arch of the aorta, or in conjunction with the left carotid. The left common carotid varies in its origin more than the right. In the majority of abnormal cases it arises with
Carotid stenting trial. This trial showed no difference between carotid stenting and carotid surgery in average risk patients. Most recently, a broad consensus of experts released a guideline document suggesting that in most cases, carotid stenting may be considered an alternative therapy to surgery. Carotid stenting can be performed under general or local anesthesia. Critical steps in the procedure are vascular access, crossing the stenosis with a wire, deploying a stent across the lesion, and removing the vascular access. A number of other steps may or may not be performed, including the use of a cerebral protection device, pre- or post-stent balloon