Carotid endarterectomy is the removal of thickened carotid intima-media atherosclerotic plaque to prevent stroke due to plaque detachment. Carotid endarterectomy is an effective method to prevent and treat ischemic cerebrovascular diseases. 1. Remove the plaque that causes arterial stenosis, smooth blood flow and improve cerebral blood supply. Sun Yuming, Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University 2. The removal of atherosclerotic plaque prevents the dislodgement of plaque and prevents intracranial arterial embolism. Indications for surgery: CEA should be performed early in symptomatic carotid atherosclerotic stenosis >70%. In patients with high risk factors for stroke, CEA should be actively performed in symptomatic stenosis >50% and in asymptomatic stenosis >60%. Bilateral carotid stenosis: if only one side is symptomatic, surgery should be performed on that side first, unless the stenosis and hemodynamic changes on the opposite side are more severe; if both sides are symptomatic, surgery should be performed on the side with significant hemodynamic changes first. If both sides have symptoms, the side with significant hemodynamic changes will be operated first, and then the contralateral side will be operated 7-14 days later. Carotid stenosis on one side and occlusion on the opposite side: TIA is often associated with the side of carotid stenosis. Stenosis of both intracranial and extracranial segments of the internal carotid artery: the same indications for surgery as (1). If postoperative symptoms persist or if the stenosis of the intracranial segment is severe, intracranial-extracranial bridging may be considered. In carotid stenosis secondary to TIA of the vertebrobasilar system, CEA can be tried. Carotid stenosis combined with coronary artery stenosis: in principle, simultaneous surgery should be performed. Selection of carotid endarterectomy incision