Diabetic underlying combined atherosclerotic occlusive disease (ASO) affects tissue supplying arteries (e.g., inferior N branch, deep femoral, and internal iliac arteries) more than conducting arteries (e.g., superficial femoral artery), and the risk of amputation in diabetic patients is approximately 5 times greater than in non-diabetic patients (34% versus 8% over 5 years), although many of these differences are due to neuropathy and local infection. Once significant arterial occlusive disease is present, patients’ life expectancy is greatly reduced (38% with diabetes versus 10% in non-diabetics within 10 years), primarily due to involvement of larger visceral arteries by atherosclerosis (e.g., coronary, carotid, renal, mesenteric artery disease). Diabetic patients with combined arterial obstruction have a lower operability and postoperative patency rate because their disease site is mostly below the level of the N artery and the outflow tract is often obstructed. The 5-year survival rate after diabetic amputation has been reported to be 39% (75% for non-diabetic), with a risk of losing the other leg of up to 50%. Therefore, early prevention is particularly important in diabetic patients, and waiting for arterial reconstruction or endoluminal therapy (PTA) to save the limb is inappropriate. What procedure should be chosen to treat arterial occlusive disease? 1.Bridge is the surgical method that should be chosen for the treatment of arterial occlusive disease. For example: aorta-bifemoral artery bridging, axillary-bifemoral artery bridging, femoral-femoral artery bridging, femoral-N artery bridging, femoral-tibial artery bridging. 2. Percutaneous endovascular angioplasty (PTA). Through the interventional method, the occluded artery is opened. It is a minimally invasive procedure that is widely performed nowadays because of the small trauma and good recent results. Balloon dilation or stent placement can be chosen. 3. Endothelial stripping or plaque removal. Applicable to scattered and isolated lesions.