Yesterday, our department successfully completed a case of difficult arterial bypass under general anesthesia, saving the patient’s left upper limbs. The patient was 63 years old female, because her upper limbs were cold and weak bilaterally, she had to wait for a while before she had the strength to shake hands for a second time, and she was often dizzy and had black eyes. It took several turns before she came to our department to find out the cause. It turned out that she had bilateral blockage of the subclavian arteries and 90% stenosis of the right common carotid artery, resulting in insufficient blood supply to the upper extremities and brain bilaterally, especially the blood supply to the left upper extremity even the lateral branch circulation was very weak, and unsuccessful surgery would directly lead to amputation. According to the patient’s condition, after careful design and preparation, the right subclavian artery was dilated and stented first in March, and the right carotid artery was stented first to solve the problem of blood supply to the brain and right upper limb. Yesterday, after thorough preoperative discussion and preparation, the patient was operated again, using artificial blood vessels to “borrow blood” from the left carotid artery to the left axillary artery, successfully completing the restoration of blood supply to the left upper limbs.