Six months ago, we admitted a 65-year-old male patient. He had recurrent paroxysmal right-sided limb weakness (this condition is called transient ischemic attack (TIA)) for 1 week prior to admission, and was admitted to our hospital after an ultrasound examination of the neck at a local hospital indicated severe stenosis of the left internal carotid artery. Recurrent TIA is one of the risk signs of stroke, and if left untreated, it is likely to develop into a stroke, and the risk is even greater when it occurs within 1-2 weeks after the onset of TIA. After admission, we actively performed stroke risk assessment with an ABCD2 score of 5. The risk of stroke within 7 days to 30 days is moderate. Pre-surgical examination and medication preparation were actively performed. The patient’s condition was closely monitored and ready to be treated with internal carotid artery stenting. Preoperative angiography revealed that the patient’s left internal carotid artery was severely stenosed and the blood flow supplying the brain was significantly slowed down, which was the culprit of the patient’s symptoms. In addition, we found that the patient’s left vertebral artery was also severely stenosed at the beginning, which was also a huge hidden problem. The feared event happened. During the night rounds of the ward on the 10th day after admission, we found that the patient had weakness in the right limb, which was worse than every time before, and was unresponsive and unable to speak. We immediately performed a cranial CT examination and ruled out intracranial hemorrhage – a contraindication sign for stentoplasty treatment – and then pushed him directly into the operating room for emergency stent implantation. Intraoperative angiography revealed that the left internal carotid artery was nearly occluded, and the degree of stenosis was worse than the previous angiography. An “umbrella” was quickly placed at the distal end of the lesion to prevent emboli from falling into the intracerebral vessels and causing a new infarction during the surgical operation. The lesion was then dilated with a balloon and a stent was implanted to open the left internal carotid artery, restoring normal blood perfusion to the left side of the brain in a timely manner. The left vertebral artery initiation was also stenosed and implanted with a stent to prevent a similar condition in the vertebral artery system. The patient regained normal consciousness on the same day after surgery and was discharged from the hospital 1 week later with no residual effects. Recently, the patient had a 6-month postoperative follow-up angiogram, and the flow in the left internal carotid artery and the stent at the beginning of the left vertebral artery was clear. This case reminds us of 2 things. One thing is that patients should take TIAs very seriously. It should be a “good thing” for the patient to have a TIA attack, and he reminded the patient to pay attention to his own cerebrovascular problems, if timely and effective preventive measures are taken, it can greatly reduce the occurrence of stroke and reduce the disability and death rate of the patient. Another thing is carotid stenosis, especially symptomatic severe stenosis (stenosis rate greater than 70%), carotid stenting is a safe and effective treatment. In our department, this technique has been performed for more than 10 years, and we have very rich clinical experience. The complication rate of adverse events of carotid stenting is controlled at about 1%, and the efficacy is better than that of drug treatment alone. Here, we also remind patients, especially middle-aged and elderly patients, to pay attention to their bodies and not to let go of any slight abnormal changes. Once symptoms are detected, seek timely medical attention and active treatment to avoid irreversible results. This is beneficial for yourself, your family, and even your country.