Recently, our department successfully treated 5 cases of complex lower extremity arterial long-segment occlusive lesions by applying bi-directional puncture access and double-balloon simultaneous dilation technique, and achieved very satisfactory results, making the application of this technique increasingly mature. The successful use of this technique marks another solid step in the treatment of complex lower extremity atherosclerotic occlusive lesions. This technique has been performed in China for only a few years, and it is a large operation, mainly for cases of long segment occlusion and severe calcification of lower extremity arteries, which can only be performed in Beijing, Shanghai and some provincial hospitals. In the past treatment, such lesions could only be punctured from the femoral artery, and the guidewire and catheter often had difficulty passing through the occluded segment, and even if they did, they often entered the subintima and could not enter the true lumen of the distal artery, resulting in a high rate of treatment failure. The double-entry puncture and double-balloon simultaneous dilation technique has solved this problem and greatly improved the success rate of endovascular treatment. When the guidewire or catheter at the inguinal puncture point cannot pass through the occluded artery or cannot enter the true lumen of the distal artery after passing through, another set of guidewire and catheter is sent upward from there to join the top-down guidewire and catheter, and two balloons are sent up and down at the same time to simultaneously dilate at the hard plaque, thus tearing the intima at the hard plaque. The arterial intima is torn, thus allowing the arterial lumen to pass up and down, and then stent implantation is performed in the conventional way, saving the patient from the pain of invasive surgery. Lower extremity atherosclerosis is a highly prevalent disease in today’s society, and the incidence of peripheral vascular disease is increasing as the number of elderly people and patients with hypertension and diabetes increase. Blood vessels are a complete system, and patients with cardiovascular and cerebrovascular diseases are also at high risk of peripheral vascular disease. Patients initially show weakness in the lower limbs, walking, feeling soreness in the lower legs, relieved after rest, recurring symptoms, accompanied by cold, numbness and other sensations in the limbs; in the middle stage, there will be signs of limb malnutrition, such as sparse sweat, dry skin, thickened toenails and lusterless lower limbs, and even muscle atrophy; in the later stage, there will be obvious limb pain, affecting sleep, and even ulcers and necrosis of the toes or limbs In the later stages, there will be obvious limb pain, affecting sleep, and even ulcers and necrosis of the toes or limbs. Early treatment of the disease is relatively easy, appropriate exercise, smoking cessation, regulation of blood pressure and blood sugar, oral vasodilator drugs can improve the condition. If symptoms further aggravate and limb pain occurs, we should pay enough attention to the fact that the arteries of the limbs are often already significantly narrowed or occluded, and patients should go to a regular hospital for ultrasound or CT angiography examination of the lower limb arteries to clarify the condition and provide timely treatment. If this time is missed, the lower limb arteries will often have long segments of occlusion and severe calcification, ulceration and necrosis of the limb, making treatment much more difficult and the success rate of treatment significantly decreases, eventually leading to the adverse outcome of amputation, which can be life-threatening in severe cases. Therefore, when you have obvious weakness and soreness in the lower limbs, you should pay enough attention to it, and should be promptly diagnosed and treated, do not mistake it for a decline in physical strength or bad lumbar spine, thus missing the best time for diagnosis and treatment.
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