Dizziness is common in daily life, and there are many causes of dizziness. Most patients only know to see a neurologist, but ignore several common vascular surgery causes: carotid artery stenosis; vertebral artery stenosis; and subclavian artery stenosis. 1, carotid artery stenosis Stroke is currently one of the major causes of death in our population. 270/100,000 men and 161/100,000 women in the 25-74 age group have an incidence of acute stroke events, and the death rate is 33% for men and 38% for women. About 30% of ischemic strokes are caused by stenotic lesions in the extracranial carotid artery. The 2-year stroke rate is as high as 26% in patients with >70% symptomatic carotid stenosis. Ninety percent of carotid stenoses are due to atherosclerosis, with the predominant site being the bifurcation of the common carotid artery. The early stage is fibrous plaque, which gradually develops into a composite plaque with ulcer formation, attached thrombus or intraplaque hemorrhage, leading to cerebral embolism or acute occlusion based on carotid stenosis, causing clinical symptoms of cerebral ischemia. Such as transient hemiparesis, monocular blindness or monocular darkness, aphasia, dizziness, limb weakness and loss of consciousness, etc. In severe cases, irreversible cerebral infarction, hemiparesis, aphasia and even death may occur. The diagnosis of carotid artery stenosis mainly relies on typical medical history, physical examination and imaging evidence such as vascular ultrasound, CT or angiography. Non-surgical treatment: For patients without contraindications, anti-platelet aggregation drugs and statins should be given whether surgery is performed or not. The recommended treatment is either Bay aspirin 100 mg per day orally or clopidogrel 75 mg per day orally. Statins can lower blood lipids and stabilize plaque, even in patients without lipid metabolism disorders, and should be given routinely. 10-80 mg of oral atopastatin (Lipitor), or pravastatin (Praglum) or simvastatin (Sulforaphane) are recommended. At the same time, risk factors such as hypertension, diabetes mellitus, hyperlipidemia, smoking cessation, alcohol abstinence, and exercise and weight loss should be controlled. Surgery: Patients with symptoms of cerebral ischemia and carotid stenosis ≥ 50%; asymptomatic patients with carotid stenosis ≥ 70% can benefit from surgical treatment. Surgery includes carotid endarterectomy and carotid stenting, each of which has its own advantages and disadvantages, depending on the patient’s general condition, the anatomical and pathological characteristics of the stenosed artery, and the local medical technology. Patients are advised to choose a department and doctor who are skilled in both surgical methods so that the doctor can choose the appropriate surgical method according to the patient’s own characteristics. 2. Subclavian artery stenosis The prevalence of stenosis or occlusion of the subclavian artery in people over 70 years of age is 13%, with the left side being significantly more common than the right side. The stenosis of the subclavian artery will cause insufficient blood supply to the ipsilateral upper limb, manifested as weakness, heaviness, pain, coldness, numbness, and even dizziness or vertigo, visual impairment, and in severe cases, syncope, and other symptoms of insufficient blood supply to the brainstem and cerebellum, which is due to the fact that when the subclavian artery is stenosed or occluded, the blood pressure of the affected upper limb will drop, and the affected vertebral artery will steal the blood supply from the healthy vertebral artery to supply the affected upper limb. This causes ischemia in the brainstem and cerebellum. In most patients, the above symptoms are not obvious at rest, but worsen with activity. Examination will reveal a weak pulse on the affected side and a blood pressure that is more than 15-20 mmHg lower than that on the healthy side. The diagnosis mainly relies on clinical symptoms and imaging examinations such as vascular ultrasound and CT. Endovascular stenting is the mainstay of treatment for this disease and is effective and minimally invasive, with endoluminal treatment being successful in over 90% of patients. Those who fail endovascular treatment or are not suitable for endovascular treatment can be cured by axillary-axillary artery bypass surgery. In some patients, the right subclavian artery is flush occluded or stenosed, and endovascular treatment will result in the right carotid artery being affected or is likely to cause cerebral infarction. The choice of surgical approach needs to be based on the patient’s specific situation, and is best performed by a vascular surgeon skilled in these two surgical approaches for targeted selection. 3.Vertebral artery stenosis The opening of the vertebral artery is a common site of atherosclerosis, and its stenosis accounts for 25%-40% of all cerebrovascular stenosis. Since the vertebrobasilar artery supplies the brainstem, cerebellum, thalamus and other vital centers, once a posterior circulation cerebral infarction occurs, 80% will result in death. Clinical symptoms caused by vertebral artery stenosis include dizziness, vertigo, diplopia, double vision, hemianopia, unstable walking, nausea and vomiting. The diagnosis relies on a typical medical history, physical examination and imaging evidence such as vascular ultrasound, CT or angiography. The main methods of pharmacological treatment are antiplatelet therapy and correction of risk factors. Surgical treatment includes open surgery and vertebral artery stenting, with the main indications being symptomatic stenosis of ≥50% of the vertebral artery opening. Surgical open surgery is technically difficult and risky to treat and is not used by most medical centers. In recent years, minimally invasive stenting has become the mainstay of treatment for vertebral artery stenosis.