As people’s standard of living improves and life expectancy increases, carotid aneurysms and carotid stenosis have become one of the most common causes of brain hemorrhage and cerebral infarction, one of the biggest health killers in modern society. Atherosclerosis, which often occurs around us, is the culprit of carotid aneurysm and carotid stenosis, a vascular lesion of the carotid system. Although we call it an aneurysm, it is not a tumor as we usually call it, but a thinning of the wall of the artery due to various factors such as atherosclerosis, trauma, inflammation, and genetic development. Depending on where it occurs, a carotid aneurysm can be as large as 1 or 2 cm or even larger, while a small one may only be 1 or 2 mm. However, carotid aneurysms should not be overlooked because they are not “tumors” or because they are small, because they can suddenly rupture and cause severe bleeding when people are excited, exert themselves, or even when they cough or defecate, which can cause a sudden increase in blood pressure. This is like the inner tube of a bicycle bulging outward after a long time; if not repaired or replaced in time, it will “burst” at any time. The carotid artery runs from the chest cavity to our brain and is the most important arterial blood vessel supplying the brain. We divide the carotid artery into two parts – intracranial and extracranial. Larger carotid aneurysms outside the cranium can be felt or even seen in the neck, while carotid aneurysms inside the cranium are much more hidden because they cannot be seen or felt, so most of them have already ruptured and bled when they are found, and such bleeding is often fatal, and many patients have lost the chance to save their lives as a result. Although carotid aneurysms are not “cancerous” or malignant tumors, once they rupture, the impact on the patient’s health can be as minor as a stroke or as serious as a life threatening condition. Although we compare having a carotid aneurysm to having a “time bomb” in the brain, we can try to remove the danger of the “time bomb” as long as it is detected at any time. Currently, there are two ways to treat a carotid aneurysm: the first is craniotomy to clip the aneurysm. This is a good and effective method, but in addition to the high technical requirements for neurosurgeons, craniotomy also has relatively high requirements for the patient’s age, general health and the condition of the carotid aneurysm, in other words, some patients are not suitable for craniotomy in order to ensure the effectiveness and safety of the operation. The second type of treatment is neurointerventional surgery. Neurointerventional surgery is performed directly from the vessel to the site of the aneurysm, simplifying the surgical steps and avoiding the problem of surgical craniotomy. Carotid artery stenting is one of the neurointerventional procedures, also known as “carotid artery stenting” or “carotid artery stenting”, which is a new high-tech minimally invasive procedure developed internationally in the last decade or so to treat cerebrovascular diseases. The stent is placed in the carotid artery to reestablish the complete shape of the vessel, so it can be used to treat carotid artery stenosis caused by atherosclerosis to increase cerebral blood supply and reduce the occurrence of cerebral ischemia and cerebral infarction; it can also be used to treat spindle-shaped aneurysms and so-called wide carotid aneurysms. In a patient with bilateral internal carotid artery aneurysms in his 80s and who also has heart disease such as atrial fibrillation and atrioventricular block, the choice of neurointerventional surgery is very appropriate because it avoids more risks due to the treatment process. If CT angiography, MRI angiography and especially cerebral angiography reveal a wide carotid aneurysm or a spindle aneurysm, then placement of a carotid artery stent is an excellent option, and more likely, a platinum spring coil will need to be placed to reinforce the vessel. The only drawback is that the cost of these neurointerventional materials is currently relatively high and not yet covered by health insurance.