Carotid artery dissection dissection is thought to be more commonly caused by severe violent trauma to the head and/or neck. An estimated 0.67% of patients admitted to the hospital after major motor vehicle accidents were found to have blunt carotid injury, including intimal dissections, pseudoaneurysms, thromboses, or fistulas. Of these, 76% had intimal dissections, pseudoaneurysms, or a combination of the two. The probable mechanism of injury for most internal carotid injuries is rapid deceleration, with resultant hyperextension and rotation of the neck, which stretches the internal carotid artery over the upper cervical vertebrae, producing an intimal tear. After such an injury, the patient
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