I. Overview Pulselessness clinically mainly refers to the absence or diminished pulsation of the radial artery in the hand, which cannot be palpated. Patients may show symptoms of upper limb ischemia, mainly manifesting as upper limb weakness, limb pain, decreased skin temperature, pale skin tone, dryness, and impaired peripheral nutrition of the limbs. Patients often feel cold in the limbs and wear more clothes than others without feeling warm. On examination, in addition to the inability to feel a pulse, the blood pressure of the affected limb is lower than the blood pressure of the opposite normal upper limb. In severe cases, patients have cold skin, cyanosis and necrosis of the finger ends. It is a clinical manifestation after narrowing or occlusion of blood vessels in the upper extremity due to aortitis or atherosclerosis. If the stenosis or occlusion is located in the subclavian artery proximal to the vertebral artery, it is also called subclavian artery steal syndrome. In addition to ischemic symptoms in the upper extremity, these patients often present with cerebral ischemic manifestations such as dizziness and blurred vision. This is because the narrowed distal limb steals blood from the brain through the vertebral artery, thus making the blood supply to the brain insufficient. The greatest danger for this kind of patients is the secondary injury caused by fainting after sudden cerebral ischemia, such as accidental injuries like cranio-cerebral bumps and bruises, some of which are fatal blows. For example, if a patient is riding a bicycle on the highway and the brain suddenly faints with ischemia, the consequences are unimaginable, because the patient falls rather suddenly and the driver is often negligent, it may lead to a car accident, so the diagnosis and treatment should be carried out as early as possible. The diagnosis of this type of patients is not difficult, if the patient has the above symptoms, then the diagnosis can be easily confirmed by ultrasound, CTA, MRA or imaging. Treatment The first step in treatment is to control the primary disease. Many patients with pulselessness, especially young female patients, are often caused by multiple aortitis. If the disease is in the active stage, we should first actively treat the aortitis, and then perform vascular opening treatment after the disease is stabilized. After the diagnosis is clear and the primary disease is controlled, vascular opening treatment should be performed as soon as possible to restore adequate blood supply to the upper limbs and brain. The traditional treatment method is surgery, which requires incision, arterial endothelial stripping with autologous vein piece repair priming, vascular bypass or artificial vascular grafting. This treatment is very invasive, expensive and has many complications. Drug therapy is generally ineffective for this type of disease. With the development of interventional techniques, this type of disease can be treated well and most patients can be completely cured. We perform a puncture cannula at the root of the thigh or the brachial artery of the upper extremity, open the vessel and then dilate the stenosed vessel through a balloon to shape it, and the problem can be solved in some people. If the lumen of the stenosed vessel is not effectively restored after dilatation, the problem can be solved by stent placement, and usually the problem can be solved in all patients by these two methods. The advantages of interventional treatment are: it is less invasive, safe, less expensive, and most of all, it can cure the disease quickly. Our department has cured many patients of this type through interventional techniques, and all of them have achieved satisfactory results without any postoperative complications.