The brain needs the blood supply from the heart to feed the brain cells, and the channel that connects these two most important organs is the carotid artery. Once a lesion occurs in the carotid artery, causing narrowing to the point of occlusion, it can pose a serious threat to a person’s life. So how should carotid stenosis be treated? Carotid endarterectomy is an internationally recognized technique for the complete clearing of plaque. Since the first successful carotid endarterectomy in the 1950s, it has been developed and improved over the past 60 years and has now become a standard procedure for the treatment of carotid stenosis with a high degree of safety. Carotid endarterectomy is performed under high-powered microscopic techniques. A small incision (3-5 cm) is made in the patient’s neck through minimally invasive means to temporarily clamp the distal and proximal ends of the carotid artery, and then the carotid artery is incised to remove the “garbage” (atherosclerotic plaque) that is blocking the vessel, resulting in a smooth inner wall and normal inner diameter. The effectiveness and safety of carotid endarterectomy has been fully verified in large-scale clinical trials in Europe and the United States, and this procedure has now become a routine procedure for the treatment of carotid artery stenosis in Europe and the United States. However, due to various reasons, carotid endarterectomy is not yet commonly used in China (carotid stenting is the main procedure in local hospitals in China), and a strict preoperative evaluation is required before surgery, which not only tests the surgical skill of the surgeon in charge, but also has high requirements for anesthesia and postoperative care (strict evaluation of the patient’s cardiopulmonary function, blood sugar and blood pressure is required) to avoid