The prevalence of lower extremity atherosclerotic occlusive disease is about 10% and tends to increase with age, with a prevalence of 15%-20% in people over 70 years of age. 2000 Pan-Atlantic Interventional Collaborative Group (TASC) reported the incidence of intermittent claudication in the European population to be 0.6%-9.2%, of which 5 The incidence of intermittent claudication in the European population was reported to be 0.6-9.2%, of which 5-10% developed into severe lower limb ischemia. The current prevalence in China is up to 15.91% in people over 60 years of age. Lower extremity atherosclerosis is closely related to risk factors such as hyperlipidemia, hypertension, diabetes and smoking, etc. About 60%-80% of patients with lower extremity atherosclerosis have at least one coronary artery lesion, and about 12%-28.4% have combined carotid stenosis. The prognosis for lower extremity atherosclerosis-occlusive disease is poor, with a 5-year mortality rate of about 30% in patients with intermittent claudication and a 5-year mortality rate of 70% in patients with lower extremity ischemia with resting pain, ulcers and gangrene. Lower extremity atherosclerotic occlusive disease is caused by atherosclerotic lesions and can exist in one or more segments of the same arterial system of the patient’s lower extremity with severe narrowing or obstruction of the arteries, and is the most common cause of chronic lower extremity ischemia in the elderly. For severe patients with severe resting pain, ulcers or even gangrene, surgical treatment should be taken promptly to reconstruct the blood flow of the limb. Without active surgical treatment, the mortality rate within 1 year can be as high as 20% and the amputation rate within 6 months can be as high as 40%. Surgical reconstruction of arterial flow in the lower extremities is the main treatment for lower extremity atherosclerotic occlusive disease (ASO). The main surgical procedures are: 1. Endarterectomy and angioplasty, which appeared before the introduction of arterial bypass and is now often combined with arterial bypass. This procedure is indicated for limited arterial stenosis or occlusive lesions, and the choice of patching is determined by the diameter of the diseased vessel. It is often used as an adjunct to surgical procedures. The indication population is mostly suitable for endoluminal treatment. 2.Vascular bypass grafting is used as a traditional method for the treatment of lower extremity atherosclerotic occlusive disease. According to the different graft materials used, it can be divided into autologous vascular bypass and artificial vascular bypass, which has a long history in foreign countries and is recognized as the classic surgical method for treating this disease, with a 3-year patency rate of 74.5% and a limb survival rate of 95.7%. 3.When patients are old and frail or have other diseases and cannot tolerate the traumatic blow of vascular bypass grafting, endoluminal intervention can be the first choice. Since it was first proposed by Dotter and Judkins in 1964, endoluminal intervention has become the main treatment for lower extremity atherosclerotic occlusive disease after more than 40 years of development, especially in the last decade or so. Endovascular intervention mainly refers to percutaneous transluminal angioplasty (PTA): the specific methods include percutaneous transluminal intra-arterial angioplasty (mainly refers to simple balloon dilation) and stenting/direct endoluminal stenting based on balloon dilation, which is a minimally invasive procedure mainly applied to segmental occlusions, with immediate success rates of 90%-96% in the iliac artery The main drawbacks of PTA are the high rate of reocclusion and the tendency to occlude the distal vessels with the formation of entrapment after intimal plaque rupture. The use of endotracheal stent not only reduces the rate of re-occlusion due to elastic retraction of the vessel, but also prevents the formation of intimal tears after PTA and improves the long-term patency rate. 4.Compound surgery refers to the combination of endovascular luminal treatment with traditional bypass surgery, aiming to simplify the operation steps, reduce trauma and improve the patency rate. Lower extremity atherosclerosis is a local manifestation of systemic atherosclerosis, often presenting multiplanar and multisegmental stenosis and occlusion. The most important advantage of the composite procedure is that it can be done in a single operation instead of several, and the key is the preoperative evaluation of the disease and the design of the surgical plan. With the advancement of catheter materials and endovascular stent design, endovascular treatment has been widely and rapidly developed in vascular surgery because of its minimally invasive, repeatable nature and reduced hospitalization time. The effectiveness of endovascular treatment for segmental arterial stenosis (especially iliac artery) has been well recognized by scholars. Endovascular techniques are generally only applicable to the treatment of short segmental arterial stenosis or occlusion. For patients with extensive arterial stenosis or occlusion, open surgical reconstructive surgery is still the predominant approach. Most scholars currently believe that the long-term patency rate of autologous saphenous vein bypass is better than that of artificial vessels, but a prospective study by Ballotta et al. showed no statistically significant difference in the 1-, 3-, and 5-year patency rates between PTFE artificial vessels and autologous suprapatellar saphenous vein bypass. 82.2% and 80.6%, respectively, and their 4-year second-stage patency rates reached 84.7% and 79.5%, respectively, with no statistically significant difference. Artificial vessel bypass is mainly used to bypass the femoral N artery with PTFE material, which is suitable for patients with poor autologous vein condition, varicose veins or saphenous veins that have been removed. It is generally believed that the 2-year patency rate of suprapopliteal bypass with PTFE can reach or approach 70%-80%, while the patency rate of infrapopliteal bypass is very low, only 30%-40%, but the composite bypass with a distal artificial vessel combined with a vein can increase the 2-year patency rate to more than 50%. Endoluminal interventions, i.e., balloon dilation or stenting: Endoluminal interventions have received widespread attention for their less invasive and faster recovery characteristics. It is now agreed that endoluminal balloon dilation and stent implantation are more effective than arterial bypass surgery for suprapopliteal lesions in grades A and B of the TASC classification, while endoluminal treatment is less effective for grades C and D of the TASC. Surowiec et al. Galied et al. summarized a large number of data on the endoluminal treatment of lower extremity arterial occlusions, including 923 balloon dilatations and 473 stent implantations, in which the 3-year patency rates were 61% for stenotic lesions, 48% for occlusive lesions, 43% for severe stenotic lesions, and 30% for severe occlusive lesions; whereas the 3-year patency rates for stent implantation were 63%-66%. The clinical significance and value of balloon dilation is that the limb salvage rate is much greater than the patency rate; balloon dilation is reproducible and can be re-dilated for restenotic lesions, which helps to improve the limb salvage rate of ischemic limbs.