In the spectrum of human mortality, stroke ranks third after coronary heart disease and tumor. The current incidence of the disease in China is about 2/1000, of which more than 75% occurs in elderly people over 65 years old, and about 1/4 of the patients die within 1 year after the onset of the disease, while half of the survivors are unable to take care of themselves. Non-smoking, control of hypertension and diabetes, and a diet low in cholesterol such as animal offal play an important role in stroke prevention, and the active treatment countermeasure of “cervical vascular incision for stroke prevention” has been carried out as a routine procedure for stroke prevention in Europe and the United States for more than 20 years, and has led to a significant decrease in the incidence of stroke in their populations. Stroke includes two major categories: cerebral ischemic lesions and cerebral hemorrhagic lesions, of which ischemic stroke caused by cerebral ischemia, i.e., cerebral infarction, accounts for 80%, while the remaining 20% of strokes are caused by intracranial hemorrhage such as hypertension and ruptured intracranial aneurysms. The main cause of cerebral infarction is the narrowing or occlusion of the arteries of the brain, and the arteries supplying the brain include a pair of internal carotid arteries and a pair of vertebral arteries. A large number of statistics show that 80% of patients with cerebral infarction have stenosis or occlusion in the internal carotid artery and vertebral artery outside the skull. The common causes include atherosclerotic stenosis of the internal carotid artery, stenosis and torsion of the vertebral artery, carotid aneurysm, carotid body aneurysm, multiple aortitis and subclavian artery steal syndrome. For cerebral infarction caused by stenosis and occlusion of the internal carotid artery and vertebral artery, stroke can be avoided if the lesion of the artery is surgically corrected before the onset of the disease to restore normal blood flow to the brain. It is crucial to detect the precursors of stroke in patients, which is not difficult under modern medical conditions. In the early stages of carotid artery stenosis, some patients only find the stenotic lesion incidentally during coronary angiography or Doppler ultrasonography of the neck vessels, which is manifested by an audible vascular murmur in the neck. After the ischemia worsens, patients may experience transient ischemic attacks in the brain. If the ischemia occurs in the carotid artery system, it manifests as sudden limb weakness or paralysis, sensory impairment, aphasia, and transient blindness in one eye, usually without impairment of consciousness. If the ischemia occurs in the vertebral artery system, it manifests as vertigo, diplopia, gait instability, and sometimes tinnitus, hearing impairment, and difficulty swallowing. Regardless of where the ischemia is located, the symptoms are usually short-lived, lasting only a few minutes to a few hours, and leaving no sequelae, but the same attacks can recur, even several times a day. This is what we usually call a “mini-stroke”. If this phenomenon lasts longer than 24 hours, it is medically known as “reversible ischemic neurological dysfunction”, and the most severe ischemia leads to a complete stroke, i.e., cerebral infarction. In the most severe cases, ischemia leads to complete stroke, i.e., cerebral infarction. In the early stage of arterial stenosis lesions, surgery can lead to complete recovery of the patient, and even in patients who have already had a cerebral infarction, surgery should be performed as long as the general condition allows, because the restoration of cerebral blood flow can prevent the occurrence of another stroke and can effectively improve the quality of life of the patient. Carotid endarterectomy, which is widely used abroad, has been performed in our hospital for nearly two decades and has achieved convincing results. This procedure involves removing the thrombus, atherosclerotic plaque and the damaged intima of the artery together at the site of stenosis to restore the narrowed arterial lumen to its normal caliber. Carotid artery-carotid artery bypass, subclavian artery-vertebral artery bypass, subclavian artery-carotid artery bypass, extracranial-intracranial artery bypass, posterior carotid minimally invasive vertebral artery reconstruction, etc. are also performed according to the different lesion sites, or a combination of various surgical modalities in combination. In recent years, with the development of minimally invasive endoluminal vascular surgery techniques, we have made a breakthrough in the treatment of carotid artery stenosis using endoluminal balloon artery dilatation and angioplasty + endoluminal vascular stent or endoluminal artificial vessel. The various reconstructive procedures of carotid arteries are not complicated and are relatively safe as long as intraoperative cerebral ischemia prevention is done. We suggest that elderly people over 60 years of age, especially those with smoking habits, or with hypertension or diabetes, or with coronary heart disease or lower limb atherosclerosis-occlusive disease, as well as those with a family history of stroke, should have a Doppler ultrasound examination of the carotid arteries once a year, and patients with ischemic symptoms and carotid and vertebral artery stenosis of more than 50% should have early surgical treatment.