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Carotid artery stenting and its complications

Ronald M Fairman, MD
Section Editors
Scott E Kasner, MD
John F Eidt, MD
Joseph L Mills, Sr, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


The proximal internal carotid artery and the carotid bifurcation are the locations most frequently affected by carotid atherosclerosis. Progression of atheromatous plaque at the carotid bifurcation results in luminal narrowing, often accompanied by ulceration. This process can lead to transient ischemic attack or stroke from arterial embolization, or thrombosis, or less commonly from hemodynamic compromise. Treatment options for carotid occlusive disease include medical management, carotid endarterectomy, and carotid angioplasty and stenting.

This topic will review procedural aspects of carotid artery stenting (CAS), including early and late complications. Other treatment options are reviewed elsewhere. (See "Management of symptomatic carotid atherosclerotic disease" and "Management of asymptomatic carotid atherosclerotic disease" and "Carotid endarterectomy".)


The left common carotid artery (CCA) originates from the aortic arch, whereas the right CCA originates from the innominate artery (figure 1). The CCA divides into the internal carotid artery (ICA) and external carotid artery (ECA) at the level of the superior border of the thyroid cartilage corresponding to the C3/C4 disc space.

External carotid artery – The ECA has multiple branches that supply the face and scalp and provide collateral circulation to the brain. These branches include (caudal to cranial) the superior thyroid, lingual, facial, ascending pharyngeal, occipital, posterior auricular, maxillary, and superficial temporal arteries.

Internal carotid artery – The ICA has no branches in the neck. The cervical segment of the internal carotid extends from the carotid bifurcation until it enters the carotid canal anterior to the jugular foramen. Detailed surgical anatomy of the internal carotid artery is described elsewhere. (See "Carotid endarterectomy", section on 'Internal carotid artery'.)

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Literature review current through: Nov 2017. | This topic last updated: Oct 30, 2017.
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