Endovascular interventions for lower extremity atherosclerosis occlusive disease have the advantages of being minimally invasive, simple to perform, accurate and repeatable, and are the direction of development in the diagnosis and treatment of vascular diseases. Currently, for the treatment of lower extremity atherosclerosis occlusive disease, most vascular surgeons and interventionalists choose endoluminal opening first whenever possible. In the process of endoluminal treatment, there are many methods and techniques that can help clinicians to successfully complete the opening of lower extremity vessels. How to choose the access route A reasonable access route is the key to successful surgery. For superficial femoral artery proximal lesions, the contralateral femoral artery access is mostly chosen; for superficial femoral artery distal lesions, the contralateral femoral artery access or the ipsilateral femoral artery parallelepipedal access can be chosen. When the contralateral femoral artery access is chosen, the application of the overturned sheath can provide sufficient support and help the smooth progress of intracavitary treatment. 2. How to access the superficial femoral artery Access to the superficial femoral artery is the key to the success of endoluminal treatment. How to determine the location of the superficial femoral artery opening is crucial. According to our experience, the location of the superficial femoral artery opening can be found on most of the axial images by carefully studying the CTA or MRA images of the lower extremity before surgery. Intraoperatively, by changing the position of the contrast head and repeated imaging, most of them can show the beginning of the superficial femoral artery. If repeated angiograms cannot be located, the position of the contralateral superficial femoral artery opening can be referred to, which is usually symmetrical. 3.How to pass the guidewire through the occluded segment For occlusion of long segments of lower extremity arteries, the following methods can be tried for opening: (1) Direct opening. (2) Twisting drill method. (3) Subendoplasty: by fitting a catheter guidewire to the proximal wall of the lesion to sharply cut the endothelium to form a sandwich, allowing the guidewire to enter the middle of the sandwich and separate toward the distal end of the lesion until the endothelium is broken through again to enter the true lumen of the distal end. (4) For those who have severe lesion calcification and the catheter guidewire cannot pass, mechanical ultrasonic ablation method can be tried to open. 4.How to return to the true lumen from under the endothelium again Using the paralleling catheter guidewire technique, trying from different directions by guidewire into tabs while controlling the direction of the proximal single-curved catheter; through the distal and proximal segments of the occluded segment by separate puncture, two-way meeting technique; returning to the true lumen by special instrument OutbackRe-entry catheter; using double balloon extension technique to help the guidewire return to the true lumen, etc. 5.How to deal with atherosclerosis occlusion secondary to thrombosis When lower limb atherosclerosis occlusion occurs, it is often combined with the formation of thrombus, and the problem of thrombus dislodgement leading to distal artery embolism often occurs when intracavitary treatment is performed. It is a good choice to lyse the fresher thrombus by pre-tubing to reveal the original stenosis or occlusive lesion and then perform endoluminal angioplasty at a later stage. Because of the diverse forms and complex morphology of occlusive lesions in lower extremity arteries, the results of different treatment methods vary. Therefore, it is crucial to individualize the treatment according to different patients in clinical work.