Large-scale global clinical trials such as NASCET, ECST, and ACAS have demonstrated the effectiveness of carotid endarterectomy (CEA) in preventing stroke, and CEA remains the “gold standard” treatment for carotid artery stenosis to date. As a preventive procedure, CEA must be performed with strict indications. The American Heart Association AHA recommends the following indications: Absolute indications: (1) one or more TIAs within 6 months with significant limited neurological deficits or unilateral blindness within 24 hours and carotid stenosis ≥ 70%; (2) one or more mild non-disabling strokes within 6 months with signs or symptoms lasting more than 24 hours and carotid stenosis ≥ 70%. Relative indications: (1) asymptomatic carotid stenosis ≥70%; (2) symptomatic or asymptomatic carotid stenosis <70%, but angiography or other tests suggest that the stenotic lesion is in an unstable state, such as stenotic surface irregularity, ulceration, or thrombosis; (3) severe restenosis after symptomatic cea surgery. < span="">In addition, CEA should be considered in asymptomatic patients with stenosis ≥70% who have an ipsilateral cerebral infarction on CT (occult stroke) or who are preparing for major surgery with an underlying blood loss and hypoperfusion state (aortic surgery, coronary artery bypass grafting, etc.).