ObjectiveTo prevent late cerebral ischemic stroke by carotid endarterectomy (CEA). Methods From Dec. 1995 to Dec. 2000, CEA was performed under local anaesthesia for 30 patients with more than 50% of carotid stenosis detected by MRA. Stemp index (SI) was measured before carotid was clamped. Temporary intraluminal shunts were used in cases with demonstrated contralateral carotid occlusion, prior cerebrovascular accident (CVA), or SI less than 40. Results At follow-up of 3～36 months, 97%(29/30) patients were at satisfactory condition, and one died perioperatively from cardiac insufficiency, and severe respiratory infection.Conclusion CEA effects a definite prevention for cerebral stroke in patients with severe carotid stenosis.