Last year, the neurosurgery intervention team of Qilu Hospital of Shandong University completed the first case of left internal carotid artery occlusion recanalization in our department. The patient, male, 60 years old, came to our hospital with “numbness of the right limb with aphasia for 20 days and immobility of the right limb for half a month”, and the cranial MRI+MRA showed occlusion of the left internal carotid artery and multiple cerebral infarcts. In view of the recent large cerebral infarction, in order to reduce the risk of cerebral hemorrhage caused by “micro-perforation” of the diseased vessel after recanalization, the patient was recommended to undergo conservative treatment temporarily and wait for the condition to stabilize before interventional treatment. Two months later, the patient was admitted to the hospital for the second time. Although the left internal carotid artery was nearly occluded, if the vessel was recanalized, the plaque might be dislodged and blocked the cerebral vessels during the operation, and there was a risk of cerebral hemorrhage due to cerebral overperfusion after the operation. The experts in the department discussed and formulated a detailed treatment plan for endovascular interventional stent implantation. After careful preparation, Prof. Yunyan Wang led the interventional team to perform stentoplasty for stenosis at the beginning of the left internal carotid artery and the opening of the left vertebral artery: the Moma umbrella was placed into the external carotid artery through the sheath of the right femoral artery, with the proximal end located in the common carotid artery. First, the micro-guide wire was carefully passed through the almost occluded left internal carotid artery, filling the protective capsule of the external carotid artery and the common carotid artery, dilating it with a balloon After the stenosis, the stent was placed, and the imaging showed good formation of the stenosis; then the ENVOY guiding catheter was replaced in the left subclavian artery, and the stent was placed in the stenosis of the opening of the vertebral artery, and the stent was dilated with a balloon, and good formation of the opening of the left vertebral artery was seen. After a week of postoperative recovery, the patient was discharged from the hospital after careful treatment by the medical staff of our department. Cerebrovascular slow occlusive lesions are typically stable lesions in the traditional sense. In patients with inadequate collateral compensation, corresponding ischemic symptoms can occur, and the severity and extent of recurrent stroke in such patients is aggravated by the presence of cerebrovascular lesions, so opening the lesion is beneficial for improving the patient’s cerebral blood supply and preventing stroke. However, there are risks associated with recanalization of cerebrovascular occlusions, such as intraoperative cerebral embolism, vascular entrapment or even vascular rupture, and postoperative hyperperfusion syndrome. Therefore, recanalization of cerebrovascular occlusion requires a thorough preoperative evaluation, strict surgical indications, and the same technical approach as for stenotic lesions to safely perform recanalization of cerebrovascular occlusion. The literature reports that in chronic occlusion of cerebrovascular lesions, the presence of “micropores”, straighter and shorter occlusion segments, and shorter occlusion time are favorable conditions for opening, while the absence of recent large cerebral infarction is an important guarantee of surgical safety, and cerebral protection devices can increase the safety of surgery. Attachment: A, C: Preoperative imaging showing: left internal carotid artery occlusion and severe stenosis of the right vertebral artery opening segment B: Postoperative imaging after cerebrovascular occlusion recanalization D: Postoperative imaging after left vertebral artery stent implantation E: Postoperative ultrasound examination after left internal carotid artery stent implantation