Polyarteritis major is a common peripheral vascular disease, also known as constrictive aortitis and pulseless disease. It is a chronic, progressive, occlusive inflammatory disease of the aorta and its branches. There are different clinical types depending on the arteries involved, but the most common type is involvement of the arteries of the head and arms, which often leads to pulselessness of the upper extremities, followed by pulselessness of the lower extremities involving the descending aorta and abdominal aorta, and hypertension due to renal artery stenosis caused by involvement of the renal arteries, as well as involvement of the pulmonary and coronary arteries. The clinical term “aortic arch syndrome”, “Takayasu’s arteritis”, “Takayasu’s disease”, “obstructive thrombotic aortopathy”, etc., actually refers to this disease or different types of this disease. The disease occurs in women, and statistics show that about 65% of female patients, the age of onset of 5 to 45 years old, female adolescents are more common, more than 85% of those over 30 years old, since the 1950s, polyarteritis has become a common peripheral vascular disease in China, a serious threat to the life and health of patients, especially adolescent female patients. The pathological changes are mainly inflammatory changes in the affected arteries, starting from the outer membrane of the artery and expanding inward, resulting in moderate lymphocyte and plasma cell infiltration and connective tissue hyperplasia in all layers of the arterial wall, and may be accompanied by elastic fiber and smooth muscle rupture, fibrosis in the inner layer and hyperplasia in the outer layer. Fibrosis of the inner layer and hyperplasia of the outer layer cause obstruction or narrowing of the arterial lumen, resulting in thrombosis and occlusion. There are four types of occlusions, namely: type I (cephalobrachial artery type), type II (renal aorta type), type III (mixed type) and type IV (pulmonary artery type). Fever, loss of appetite, peripheral discomfort, weight loss, night sweats, arthralgia, chest pain, and fatigue are the most common symptoms at the onset of the disease, and in a few cases, there are no symptoms before the onset of the disease. The manifestations of head and arm artery type are mainly some manifestations of cerebral ischemia, such as dizziness, vertigo, headache, loss of strength, etc. In severe cases, there may be convulsions, aphasia, hemiparesis or coma, etc. Head and facial ischemia may reach nasal septal perforation, ulceration of the upper jaw or ear shell, tooth loss and facial atrophy, etc. Upper limb ischemia can lead to upper limb weakness, soreness, limb numbness, and even muscle atrophy. Treatment: In the case of medical hormone therapy, i.e. after normalization of blood sedimentation, surgical treatment. According to your case, the surgical treatment is mainly for the ischemia of the cephalic phase. According to my experience and international guidelines, interventional treatment of aortitis is not effective and only vascular bypass therapy is the only option.