Carotid atherosclerosis, or carotid atherosclerosis, is a manifestation of systemic atherosclerosis in the carotid arteries, usually occurring in adolescence and progressively worsening with age. It is now considered to be closely related to the occurrence of ischemic stroke in the elderly. The early stage of carotid atherosclerosis is characterized by intima-media thickening, followed by the gradual formation of atherosclerotic plaques, on the basis of which intraplaque hemorrhage, plaque rupture and dislodgement, wall thrombosis and secondary stenosis occur, causing corresponding hemodynamic changes and leading to the occurrence of ischemic cerebrovascular events. Etiology of carotid atherosclerosis Like atherosclerosis, carotid atherosclerosis is influenced by a variety of factors. Among them, age >60 years, male, long-term smoking history, history of hypertension, history of diabetes mellitus and hyperlipidemia are risk factors for carotid plaque formation. Clinical manifestations of carotid atherosclerosis The symptoms of carotid atherosclerosis mainly depend on the degree of lumen narrowing and the nature of the plaque. According to whether the symptoms are related to cerebral ischemia, there are two categories: symptomatic and asymptomatic: 1. Symptomatic (1) Transient ischemic attack (TIA) can be manifested as transient unilateral limb sensory and motor impairment, monocular blindness or aphasia, which usually lasts only a few minutes and recovers completely within 24 hours after the onset. (2) Ischemic stroke commonly presents with sensory and/or motor deficits in one limb, aphasia and, in severe cases, coma. (2) Ischemic stroke commonly has clinical symptoms of sensory and/or motor deficits in one limb and aphasia. 2.Asymptomatic Many patients with carotid atherosclerotic disease do not have any clinical neurological symptoms or only have some non-specific manifestations, such as dizziness, headache, syncope, etc. Carotid atherosclerosis treatment 1.Lifestyle changes include smoking cessation, strengthening exercise, weight control, low salt and low fat diet, etc. (2) Anti-platelet therapy: Prophylactic application of anti-platelet drugs can significantly reduce the incidence of ischemic cerebrovascular disease, oral aspirin or clopidogrel can be taken daily; (3) Intensive lipid-lowering therapy: Several clinical studies have confirmed that statins can stabilize plaque and significantly reduce the incidence of cardiovascular and cerebrovascular events and death rate. (3) Intensive lipid-lowering therapy: Several clinical studies have shown that statins can stabilize plaque and significantly reduce the incidence of cardiovascular events and mortality. The changes of liver enzymes and muscle enzymes should be monitored regularly during the course of administration. 3.Surgical treatment The purpose of surgical treatment is to prevent the occurrence of ischemic stroke. Clinically, doctors will decide whether to operate and what kind of surgery to use according to the degree of stenosis caused by carotid plaque and the stability of the plaque, combined with the patient’s symptoms and basic conditions. (1) Carotid endarterectomy (CEA): Surgery to peel off the thickened carotid endartery and sclerotic plaque, mostly under general anesthesia, requires that the patient has no serious cardiac, pulmonary or other systemic diseases. (2) Carotid artery stenting (CAS): This is a minimally invasive procedure, in which a stent is placed at the location of the lesion to open up the narrowed vessel wall and restore blood flow to the lesion. Oral dual antiplatelet therapy with aspirin and clopidogrel is required 3 to 5 days prior to surgery. The long-term patency rate of CAS is currently considered to be the same as that of CEA. Treatment of carotid atherosclerosis can have a chance of recovery using lifestyle changes, medication or surgery, depending on the condition, but the emphasis is on prevention. Doctors said that the prevention of carotid atherosclerosis disease mainly requires good lifestyle habits, reasonable diet, adherence to appropriate exercise and exercise, and adjustment of the state of mind.