Background and Aims: After the chronic occlusion of unilateral internal carotid artery (ICA), there are 3%-5% of patients will still have symptoms of cerebral ischemia, such as black-outs and dizziness. However, there are few cases of clinically diagnosed this condition in China at present, and the understanding of its operation method is insufficient. Therefore, this study was conducted to preliminarily investigate the safety and efficacy of the endarterectomy of the external carotid artery (ECA), common carotid artery (CCA) or ICA as the main method combined with the occlusion or resection of the residual lumen of the ICA in treatment of the carotid stump syndrome (CSS). 
Methods: The clinical and follow-up data of 9 patients diagnosed with CSS and treated by endarterectomy from August 2015 to June 2018 were analyzed retrospectively. Of the patients, 6 cases were males and 3 cases females, with an average age of 67.3 years. The changes in clinical symptoms before and after operation were compared. The scorers of the modified Rankin Scale (mRS) before and after operation were recorded.
Results: All procedures were uneventfully completed in the 9 patients. After operation, the neurological symptoms such as dizziness and limb weakness were relieved and improved, and the frequency of TIA was significantly reduced, but the visual loss in one patient could not be relieved due to the long period of blindness. Two patients (22.2%) had headache, dysphoria and other high perfusion manifestations, which were improved after decompression and dehydration treatment, without serious complications such as cerebral hemorrhage and cerebral infarction; two patients had choking cough when drinking water after operation, but basically recovered one week later. The scores of mRS for all patients were lower than those before procedure (≥1).
Conclusion: Endarterectomy of the ECA, CCA or ICA as the main method combined with the occlusion or resection of the residual lumen of the ICA is a safe and feasible method for CSS, with satisfactory short-term follow-up results. So, it can be used as a surgical method when the drug treatment fails.