By the end of December 2009, Prof. Wang Tao’s medical group of neurosurgery has carried out nearly 50 cases of microscopic carotid endarterectomy with remarkable results, among which the oldest was 87 years old and the youngest was 35 years old, while related basic experimental research was carried out. Both the quantity and quality of surgery are in the forefront of domestic neurosurgical colleagues. Cerebrovascular disease is one of the three major diseases that seriously threaten human life and health, and in China, its morbidity, disability and mortality rate is the first, with 1 million people dying of stroke every year, accounting for about 20% of the total mortality rate of the population. Stroke due to cerebrovascular disease is the leading cause of functional impairment and reduced quality of life. 20% of survivors require specialized care and 15-30% are left with permanent disability. In China, 2 million new strokes occur each year and approximately 1.5 million people die each year from cerebrovascular disease, with 6-7 million patients surviving. About 3/4 of the stroke survivors are incapacitated to varying degrees, and about 40% of them are severely disabled. The annual cost of stroke treatment in China is estimated to be more than 10 billion yuan, and the annual expenditure for stroke is 20 billion yuan, which is a heavy economic burden for the country and many families. Acute cerebrovascular accidents, also known as strokes and cerebral strokes, occur mostly in middle-aged and elderly people, affecting patients’ quality of life in mild cases and paralysis, aphasia, dementia and even death in severe cases. Cerebrovascular diseases have become one of the most economically costly diseases in medicine, bringing a heavy burden to individuals, families and society. The annual medical costs for the treatment of cerebrovascular diseases in China are in the tens of billions of dollars! In the past, people tend to focus on hemorrhagic cerebrovascular diseases, in fact, 75-90% of cerebrovascular diseases are ischemic strokes! And most ischemic strokes have varying degrees of carotid artery stenosis. Therefore, the prevention and treatment of ischemic cerebrovascular disease is the top priority of our medical work. Carotid artery stenosis is mainly caused by atheromatous plaque formation in the bifurcation of the carotid artery. High risk factors for plaque formation include smoking, hypertension, hyperlipidemia, diabetes and obesity. The most serious consequence of carotid stenosis is stroke, which is caused by narrowing of the carotid artery reducing cerebral blood flow below a critical state, or by plaque fragments or thrombus dislodging and drifting with blood flow to the brain to block larger cerebral arteries, which can cause a large cerebral infarction. In layman’s terms, the surgery is to make a small incision in the patient’s neck, cut open the narrowed carotid artery, remove the hardened atheroma, and then close the incision, and if the stenosis is severe, a patch can be added to widen the vessel. Nowadays, in neurosurgery, most patients who undergo this procedure are able to move around after 24 hours. The procedure is modest, the results are real, the neurosurgeons often do it under a microscope, the safety is better, and the procedure is not expensive and suitable for universal implementation. The idea of surgical repair of carotid stenosis for stroke prevention has become so widely accepted that in the United States, with a population of just over 200 million, 150,000 patients were treated with this procedure in 1998 alone! Ninety-one percent of these patients underwent carotid endarterectomy, but in China, with a population of more than 1.3 billion, the procedure is estimated to be performed in less than a thousand cases per year! With such a huge gap, is the prevalence of atherosclerotic carotid stenosis in China not high? Not at all! The authors believe that it is mainly a matter of perception. Not only do most patients believe that they should not undergo surgery until it is absolutely necessary, but many clinicians also lack the knowledge to do so, resulting in many patients not being promptly examined and confirmed to have carotid artery stenosis. It is important to understand that the main purpose of the surgery is to prevent or delay the occurrence of brain infarction, because brain cells do not regenerate once they die. Once a large cerebral infarction has occurred, complete hemiparesis, aphasia or even coma, the surgery is not possible! Fortunately, China’s neurosurgery community has paid attention to this problem, and in recent years, many large and medium-sized cities in China have gradually carried out this work, and the surgical treatment of ischemic cerebrovascular disease has been included in the national “Ninth Five-Year Plan”, “Tenth Five-Year Plan” and “Eleventh Five-Year Plan”. “The Department of Neurosurgery has been in the forefront of the national “Eleventh Five-Year Plan” major support project on comprehensive treatment technology system for stroke surgery. “Our hospital has also become the base of carotid artery stenosis screening of the Ministry of Health. In order to popularize the knowledge of carotid stenosis, we established the “Carotid Stenosis Website http://www.sjwk.net”. In fact, in addition to surgical treatment (CEA), there is also carotid artery stenting (CAS) for moderate to severe carotid stenosis. Treatment guidelines and expert consensus in the United States, Europe, Australia, Japan and other countries consider carotid endarterectomy (CEA) as the accepted “gold standard” for the treatment of carotid stenosis. It is believed that in the near future, carotid endarterectomy will become the most common and routine procedure performed in the operating room every day in China, as it is in developed countries. The easiest way to screen for carotid stenosis is the inexpensive, non-invasive carotid ultrasound. The aggressive implementation of this procedure in our country has far-reaching implications for improving patient health and quality of life. Because of our diet, we have a high prevalence of carotid artery stenosis, especially in the northern region, and therefore we should pay extra attention to it. It is important to establish the concept that stroke can be actively prevented, which has been well scientifically proven. Actively treat carotid stenosis and prevent strokes so that more elderly people can live healthy and happy lives!