Common carotid artery At approximately the level of the fourth cervical vertebra, the common carotid artery splits ("bifurcates" in literature) into an internal carotid artery (ICA) and an external carotid artery (ECA). While both branches travel upward, the internal carotid takes a deeper (more internal) path, eventually travelling up into the skull to supply the brain. The external carotid artery travels more closely to the surface, and sends off numerous branches that supply the neck and face. At the lower part of the neck the common carotid artery is very deeply seated, being covered by the integument, superficial fascia, the platysma muscle, deep
Carotid endarterectomy (CTA) or invasive angiography. Revascularization of symptomatic stenoses has a much higher therapeutic index compared to asymptomatic lesions. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) are both large randomized class 1 studies which have helped define current indications for carotid endarterectomy in symptomatic patients. The NASCET found that for every six patients treated, one major stroke would be prevented at two years (i.e. a number needed to treat (NNT) of six) for symptomatic patients with a 70–99% stenosis, where percent stenosis was defined as: Symptomatic patients with less severe carotid occlusion (50–69%)