Cerebral infarction, commonly known as “stroke”, is a serious threat to human survival and quality of life, and is now ranked among the top three causes of death in China’s population. There is no difference with normal people. Some people may not have any symptoms for several years, so these people tend to take the disease lightly and think they are fine, but in fact, the hidden problems of patients are neglected. Strokes seem to start in the brain, but the root of the problem is in the neck. According to statistics, 60% of strokes are caused by atherosclerosis of the carotid artery. Embolism caused by sclerosis, stenosis and plaque dislodgement at the bifurcation of the carotid artery or secondary thrombosis of the internal carotid artery can lead to cerebral infarction. Patients with hypertension and hyperlipidemia are a high-risk group for stroke. Currently, carotid ultrasound, magnetic resonance angiography, cerebral digital subtraction angiography and CT angiography are often used to determine the site and degree of carotid artery stenosis. Of these, ultrasound is the preferred test and cerebral digital subtraction angiography is the gold standard. All of these provide a scientific basis for the detection of pre-stroke lesions and timely treatment of patients. If ultrasound and angiography determine that the carotid artery has more than 50% significant stenosis, or has intimal plaque and ulcers, then treatment with medical drugs will have limited effect. The wise choice is surgical treatment – carotid endarterectomy or carotid stenting. Carotid endarterectomy has been performed for more than 50 years to remove thickened carotid intima and plaque ulcers, improve cerebral blood supply, and cut off the source of emboli. As early as 1953, DeBakey successfully performed endarterectomy of the common and internal carotid arteries in a 53-year-old patient with recurrent TIAs, and in the 1990s, several multicenter, prospective, randomized, controlled clinical trials of CEA were published in Europe and the United States, showing that CEA was an effective treatment for severe carotid stenosis. Other studies have shown that 60% of patients with carotid ischemic cerebral infarction recur within two years of the first onset, and 50% of these patients eventually die from recurrent cerebral infarction. If treated with carotid endarterectomy after the first stroke, the 1-year recurrence rate of the disease can be reduced from 5% to 20% to 2%. This procedure is now well established. In North America, approximately 20,000 patients are treated each year. The procedure requires the removal of the diseased arterial lining to smooth the inner wall of the carotid artery and restore the internal diameter to its normal size. The patient can return to normal life one to two days after surgery. Although surgical prevention of stroke is effective, it is very traumatic and risky, while carotid stenting is a new minimally invasive method for stroke prevention, which is comparable to surgical prevention, and it is simple, effective, less traumatic and has a success rate of over 95%. It does not require craniotomy and exposure of brain tissue, has few complications, and is associated with a rapid postoperative recovery, and can be discharged from the hospital in approximately 1 day. Carotid artery stenting is performed by inserting a vascular stent into the carotid stenosis to shape the vessel. The combined use of cerebral protection device can reduce the complications of thrombus dislodgement and cerebral embolism. The Department of Vascular Surgery of Huashan Hospital of Fudan University is one of the early units in China to carry out carotid endarterectomy and carotid stenting to prevent ischemic stroke, and has accumulated considerable clinical experience. At present, the routine use of carotid diversion tube and arterioplasty with vascular patch can reduce the intraoperative cerebral ischemia time to almost zero, and the incidence of postoperative restenosis is also greatly reduced. Thus, the safety of the procedure is greatly improved. Of course, stroke treatment focuses on prevention, and the “three lines of defense” should be well managed. The first is to prevent hypertension, hyperlipidemia, hyperglycemia and atherosclerosis by adjusting the diet and changing the lifestyle. It is especially important to prevent strokes in the fall and winter months. Secondly, if symptoms such as transient dizziness, headache, slanting of the mouth and numbness of the limbs occur, you should go to the hospital as soon as possible, take the initiative to check and treat them actively to avoid cerebral infarction. Third, once there is a transient black clouding or had a stroke attack, as well as retinopathy should be hospitalized as soon as possible for systematic examination and treatment, change passive treatment to active prevention, and prevent the problem before it happens.