Cerebral infarction, commonly known as “stroke”, is a serious threat to human survival and existence. These diseases mostly occur in middle-aged and elderly people over 50 years old, and early patients mostly show symptoms of transient cerebral ischemic attack: dizziness, headache, blurred vision, but they can soon return to normal, no different from normal people. Some people may not have any symptoms for several years, so these people tend to take the disease lightly and think they are fine, but in fact, the hidden problems of patients are ignored. Strokes seem to start in the brain, but the root of the problem is in the neck. According to statistics, 60% of strokes are caused by atherosclerosis of the carotid artery. Embolism caused by sclerosis, stenosis and plaque dislodgement at the bifurcation of the carotid artery or secondary thrombosis of the internal carotid artery can lead to cerebral infarction. Patients with hypertension and hyperlipidemia are a high-risk group for stroke. Currently, carotid ultrasound, magnetic resonance angiography, cerebral digital subtraction angiography and CT angiography are often used to determine the site and extent of carotid stenosis. Of these, ultrasound is the preferred test and cerebral digital subtraction angiography is the gold standard. All of these provide a scientific basis for the detection of pre-stroke lesions and timely treatment of patients. If ultrasound and angiography determine that the carotid artery has more than 50% significant stenosis, or has intimal plaque and ulcers, then treatment with medical drugs will have limited effect. The wise choice is to perform surgical treatment with a carotid endarterectomy to remove the thickened carotid intima and plaque ulcers, improve the cerebral blood supply and cut off the source of the emboli. Carotid endarterectomy has been performed for more than 50 years. As early as 1953, DeBakey successfully performed endarterectomy of the common and internal carotid arteries in a 53-year-old patient with recurrent TIAs, and in the 1990s, several multicenter, prospective, randomized, controlled clinical trials of CEA were published in Europe and the United States, showing that CEA was an effective treatment for severe carotid stenosis. Other studies have shown that 60% of patients with carotid ischemic cerebral infarction recur within two years of the first onset, and 50% of these patients eventually die from recurrent cerebral infarction. If treated with carotid endarterectomy after the first stroke, the 1-year recurrence rate of the disease can be reduced from 5% to 20% to 2%. This procedure is now well established. In North America, approximately 20,000 patients are treated each year. The procedure requires the removal of the diseased arterial lining to smooth the inner wall of the carotid artery and restore the internal diameter to its normal size. The patient can return to normal life in 1 to 2 days after surgery. The Department of Vascular Surgery of Huashan Hospital of Fudan University is one of the first units in China to perform carotid endarterectomy and carotid stenting to prevent ischemic stroke, and has accumulated considerable clinical experience. At present, the routine use of carotid diversion tube and arterioplasty with vascular patch can reduce the intraoperative cerebral ischemia time to almost zero, and the incidence of postoperative restenosis is also greatly reduced. Thus, the safety of the procedure is greatly improved. Of course, stroke treatment focuses on prevention, and the “three lines of defense” should be well managed. The first is to prevent hypertension, hyperlipidemia, hyperglycemia and atherosclerosis by adjusting the diet and changing the lifestyle. It is especially important to prevent strokes in the fall and winter months. Secondly, if symptoms such as transient dizziness, headache, slanting of the mouth and numbness of the limbs occur, you should go to the hospital as soon as possible, take the initiative to check and treat them actively to avoid cerebral infarction. Thirdly, once there is a transient black clouding or had a stroke attack, as well as retinopathy should be hospitalized as soon as possible for systematic examination and treatment, change passive treatment to active prevention, and prevent the problem before it happens.