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
Carotid body may involve mitochondrial oxygen sensors and the haem-containing cytochromes that undergo reversible one-electron reduction during oxidative-phosphorylation. Haem reversibly binds O with an affinity similar to that of the carotid body, suggesting that haem containing proteins may have a role in O, potentially this could be one of the complexes involved in oxidative-phosphorylation. This leads to increases in reactive oxygen species and rises in intracellular Ca. However, whether hypoxia leads to an increase or decrease in reactive oxygen species is unknown. The role of reactive oxygen species in hypoxia sensing is also under question. The oxygen dependent enzyme haem-oxidase has also