The carotid artery is the main blood vessel leading from the heart to the brain. Carotid artery stenosis is mostly due to the narrowing of the carotid artery lumen caused by atheromatous plaques in the carotid artery, which can gradually develop to complete occlusion. Cerebral ischemic stroke often causes disability and even death. Globally, after ischemic heart disease, stroke is the second leading cause of human death and the most important factor in human disability. According to foreign literature, 85% of strokes are ischemic, and 1/3 of ischemic strokes are caused by carotid artery disease.1 Evidence that carotid artery disease causes stroke Prospective studies of symptomatic carotid artery stenosis have confirmed that the annual incidence of stroke in these patients is approximately 2%. Three quarters of strokes occur on the same side of the stenosis. The North American Carotid Endarterectomy Trial Group (NASCET) reported that 95% of strokes in patients treated with medications occurred ipsilateral to the stenosis. the ECST also reported that 90% of ischemic strokes occurred ipsilateral to the stenosis. The beneficial effect of carotid endarterectomy in reducing stroke in patients with severe carotid stenosis (symptomatic or asymptomatic) provides further evidence of the etiology of carotid stenosis. The likelihood of stroke in patients with >75% carotid stenosis is 10,5% within 1 year and 30% to 75% within 5 years; in patients with 70% to 90% carotid stenosis combined with cerebral ischemia, 26% to 28% will have a stroke within 1 year. 2, TIA, the prelude to stroke, pay attention to the symptoms of carotid artery stenosis, early diagnosis and treatment and reduce the incidence of ischemic stroke is essential. Due to insufficient blood supply to the brain caused by carotid artery stenosis, early symptoms mainly include drowsiness, memory loss and inability to concentrate at work. In severe cases, the symptoms of transient ischemia may occur: dizziness, transient black haze, loss of consciousness, and inability to move half of the body. It has a sudden onset, usually lasts only a few minutes to a few hours, and can be fully recovered within 24 hours without sequelae. The frequency of its attacks may be as high as several times a day, or as low as once in a few weeks, months or even a year or two. This transient, reversible, recurrent condition is called transient ischemic attack (TIA), commonly known as mini-stroke. It is often referred to as a prelude to a stroke because nearly 1/3 of these patients will have a stroke within 5 years. The stenosis caused by carotid atheromatous plaque, and the microemboli dislodged from the plaque into the brain, can cause localized microembolism in the brain causing cerebral ischemic symptoms. Physiological compensatory response can make the embolus dissolve, blood vessel reopening, cerebral blood supply restoration, ischemic symptoms immediately disappear, so the symptoms of transient cerebral ischemia appeared in the clinic. 3.Preventing stroke, surgery shows its ability At present, there are three ways to treat carotid artery stenosis: drugs, vascular stenting, plaque stripping in the carotid artery. Drugs are usually suitable for patients with mild symptoms, mainly oral enteric-coated aspirin; carotid artery stenosis in less than 70% of patients with symptoms are not obvious, you can consider vascular stenting; carotid artery stenosis reaches more than 70% of patients with obvious symptoms are preferred to do carotid endarterectomy. Compared with vascular stenting, carotid endarterectomy is not only economical, but also has a higher safety factor. Carotid endarterectomy has long been a common procedure in Western countries to prevent stroke in patients with TIA caused by carotid artery stenosis who are indicated for surgery. In the United States, thousands of patients with TIA undergo this procedure each year for stroke prevention. Epidemiologic surveys have also proved that in the years following the surgery, the incidence of stroke in those who underwent the surgery was only 1/6 of that in those who did not. carotid endarterectomy is one of the common surgeries in peripheral vascular surgery, and the method of the surgery is to incise the carotid artery, remove the limited plaque of the narrowed arterial segment, and strip off the endothelial lining. Since the narrowing of the artery is lifted and the hardened arterial plaque is removed, this procedure not only treats the symptoms of TIA, but also prevents the occurrence of stroke. Of course, this procedure also carries the risk of causing cerebral ischemia, and not all patients with TIA need this procedure. First, there must be imaging to confirm carotid stenosis. The internationally recognized indication for carotid endarterectomy is the degree of carotid artery stenosis, with stenosis of more than 70% as the criterion for surgical indication, and of course there are also some very specific indicators, such as the presence or absence of clinical symptoms. So far, the treatment of stroke is far from perfect. At present, the focus of medical care is to strongly advocate the prevention of the main, once the real day of the attack, due to the disease itself has a high mortality rate, disability and recurrence rate, resulting in a variety of means of treatment, but the consequences are still not optimistic. As far as carotid endarterectomy is concerned, it is theoretically a near-perfect procedure, and the current surgical methods are becoming more sophisticated by the day. Carotid endarterectomy is a major step towards conquering stroke. Now there is a new minimally invasive method, which is percutaneous perforation angioplasty with endoprosthesis of the vascular lumen treatment, can partially replace the carotid endarterectomy. elderly people over the age of 60 years old, who suffer from high blood pressure, coronary heart disease and other diseases should go to the hospital every year to do a Doppler ultrasound or CT, angiography and other examinations, in order to find out the disease at an early stage. More attention should be paid to the sometimes darkness in front of the eyes, sudden unconsciousness, and inflexibility of hands and feet, etc., and they should go to regular hospitals immediately for appropriate examination and treatment.