In patients with SCAS >70%, SCAS 50–70%, and ACAS, the NNTs are 6–7, 15 and >150, respectively [7,8,9].This benefit in surgical treatment could be even lower nowadays if we consider recent advances in secondary stroke prevention with the introduction of angiotensin-converting enzyme (ACE) inhibitors, statins, and better compliance in the control of classical vascular risk factors [12,13]. The gene discussed is ACE; the disease is Stroke.