”People get old before their legs get old”, this is an old saying widely circulated among the people. So is this saying right or not? I should say, in a certain sense this saying is right. People in old age are prone to leg and foot diseases, many elderly people have leg pain, walking inconvenience, etc.. However, because of the old saying “people get old before their legs get old”, many people take it for granted that leg pain and walking inconvenience are caused by old age, and take it for granted that leg pain is caused by osteophytes or osteoporosis, so they can just buy some medicine or take calcium supplements. Therefore, in this sense, the old saying “people get old before their legs get old” is not true, because it will mislead many elderly people not to actively diagnose and treat the problem, thus delaying the treatment. This is because some leg pains not only bring serious inconvenience and impact to the daily life of the elderly, but also may cause amputation and even life-threatening results due to delayed treatment. This is due to the fact that a significant number of leg pains are actually caused by a disease called lower extremity atherosclerosis-occlusive disease. What is atherosclerosis-occlusive disease? Let’s say that the human blood vessels are like the drainage pipes at home, over time, the water pipes will rust, impurities and dirt in the water will be deposited, and to a certain extent will cause the pipes to be blocked. The same is true of human blood vessels, the long-term role of various adverse factors, to middle and old age may occur atherosclerosis changes, the original smooth tube wall will give birth to a lot of hardened plaque, plaque accumulation to a certain extent will lead to narrowing or even occlusion of the blood vessels. Once blocked, it will cause ischemic disease in the corresponding supply part. For example, if the coronary artery in charge of the heart is blocked, myocardial infarction will occur, and if the cervical and cerebral vessels are blocked, brain infarction will occur, leading to stroke. Similarly, a blocked artery in the leg will cause leg pain, and in serious cases, it will lead to ischemic necrosis of the limb. With the improvement of people’s living standards and the increasing trend of population aging, the incidence of various diseases caused by atherosclerosis is also on the rise. China is also a major consumer of tobacco and a country with a high incidence of hypertension, diabetes and other diseases, all of which are high-risk factors for atherosclerotic occlusive disease of the lower limbs. Therefore, in addition to promoting a healthy diet and active exercise, we must also emphasize complete cessation of smoking and effective control of chronic diseases such as diabetes and hypertension. What are the clinical manifestations of lower extremity atherosclerotic occlusive disease once it is acquired? Early symptoms may include cold feet and slight numbness. If the disease worsens, intermittent claudication may occur, that is, painful soreness in the lower legs or feet when walking, and the need to stop and rest for a moment before continuing to walk, and similar symptoms may occur again after walking. This stage is often confused with orthopedic diseases such as lumbar disc herniation. Later, the pain in the lower extremities may be worse at rest, especially at night. Then, ulcers or blackened necrosis of the toes may occur. Especially in diabetic patients, the rate of severe limb ischemia such as necrosis and ulceration is higher. The best time for surgical treatment is before the appearance of limb necrosis. I often encounter patients who have already had toe necrosis coming to the clinic. Why do they come to the clinic so late now with such advanced medical conditions? In fact, many of them think that it is normal to have pain in their legs and feet when they get older and can’t walk very far, so they put off going to the clinic. There are also a lot of people who have been consulting orthopedic, Chinese medicine, rheumatism, etc., but never thought that it might be a vascular problem, until the toes are black, then they just wake up. Therefore, the elderly should go to the hospital to see a vascular surgeon promptly if the above clinical manifestations appear, so that a clear diagnosis can be made as soon as possible. In fact, whether the leg pain is caused by arterial occlusion can be roughly determined by simply feeling the pulse on the foot, the key is to think about and pay attention to this disease. Once the diagnosis is clear, depending on the severity of the symptoms, you can choose different methods of treatment such as medication, endoluminal intervention or surgical bypass surgery. Interventional intraluminal therapy, in particular, can be done under local anesthesia by using catheters, guidewires, balloons, stents and other tools to reopen the occluded blood vessels, which can improve walking ability, relieve pain, promote ulcer healing and avoid amputation. This method is simple and minimally invasive, with precise efficacy, and is especially suitable for elderly patients who are old, at high risk, and in poor physical condition.