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%
Internal carotid artery is known as the carotid sinus or the carotid bulb. The ascending portion of the cervical segment occurs distal to the bulb, when the vessel walls are again parallel. The internal carotid runs vertically upward in the carotid sheath and enters the skull through the carotid canal. During this part of its course, it lies in front of the transverse processes of the upper three cervical vertebrae. It is relatively superficial at its start, where it is contained in the carotid triangle of the neck, and lies behind and medial to the external carotid, overlapped by the sternocleidomastoid muscle, and