The effects of upregulation of Neu5Ac and activation of the Rho/Rho kinase signaling pathway may contain monocyte/macrophage migration, transport of oxidized low-density lipoprotein, endothelial dysfunction, and phenotypic transition and proliferation of vascular smooth muscle cells, which may be involved in the process of terminal internal carotid artery stenosis. This evidence concerns the gene RHO and endothelial dysfunction.