Abdominal aorta saddle embolism (ASE) is a rare but extremely dangerous disease with high mortality and amputation rates requiring emergency surgery, and correct and timely treatment is very important. Due to the high level of obstruction, the distal limb is more prone to necrosis than the unilateral iliac or femoral artery embolism, which can easily lead to death due to hyperkalemia or acute renal failure in MNMS (myopathy-nephropathy metabolic syndrome); the degree of azotemia, hyperkalemia, myoglobinuria and metabolic acidosis after surgery is severe; preoperative and postoperative abdominal aortic block and opening make Therefore, the condition is critical and complicated, and it is impossible to dissolve the fibrous embolus with non-surgical embolization therapy, and it is impossible to completely open the collateral circulation in the short term, so early surgery is the only curable method. The use of Fogarty catheter for bilateral femoral artery dissection has become the best procedure for the treatment of abdominal aortic transverse embolism, the advantages of which are: (1) reducing the impact of anesthesia on the patient’s blood circulation and respiratory system; (2) less trauma, less blood loss, fewer surgical complications, and simpler and less time-consuming surgery; (3) lower morbidity and mortality rate. During the operation, special attention should be paid to: (1) observe the proximal blood spray of the femoral arteries bilaterally, if not much blood spray is found, it should be thought that there is a possibility that the embolus may be dislodged to the opposite side during embolization, and the embolus should be retrieved again. The proximal arterial blood spray and the removal of the distal rat-tailed embolus tail and the obvious reverse blood flow are the signs of successful embolization. (2) After bilateral femoral artery embolization, embolization of the distal artery of the limb should be performed routinely to prevent the thrombus from dislodging to the distal end and causing embolism. (3) After embolization, inject urokinase 250,000 u into the distal vessel to dissolve the micro thrombus. (4) Observe the degree of ischemia of both lower limbs before operation, and if there is severe pain, muscle stiffness, tension blisters and other prodromal symptoms of extensive ischemic necrosis in the affected limbs, fasciotomy and decompression should be performed in time during operation, and if necessary, amputation should be performed decisively. (5) Release 200-300ml of blood from femoral vein on each side before opening blood flow after embolization to reduce the absorption of toxins and protect renal function. If conditions permit, hemodiafiltration therapy will be performed instead. Patients with abdominal aortic spinal embolism have a large and rapid entry of toxic metabolites into the systemic circulatory system in the ischemic limb during and after surgery, leading to severe azotemia, hyperkalemia, myoglobinuria and metabolic acidosis, which are the main causes of high mortality in patients with abdominal aortic spinal embolism. Therefore, close intraoperative and postoperative monitoring of the cardiac and renal organs, replenishment of alkaline fluid after the obstructed artery is unblocked, and timely cardiac and diuretic therapy are necessary. If necessary, blood purification should be performed as follows: after successful embolization, free and reveal the femoral vein and block it, then open the artery, and at the same time puncture the distal end of the blocked vein with a blood collection bag connected with a needle, so that the venous blood of the affected limb flows naturally into the blood collection bag, at this time, the calf and thigh can be constantly squeezed to assist in blood collection, and blood purification techniques are applied on the spot, and immediately returned through the superficial veins of the normal limb, and finally open the blocked vein again. When the blood flow is opened, 125ml of 5% sodium bicarbonate is administered intravenously to prevent acidosis and protect kidney function. Through this method, the toxic substances in the blood of this type of patients were significantly reduced, thus significantly reducing the amount of intraoperative and postoperative alkaline drugs, mannitol and other infusion rate, further reducing the burden on the heart, ensuring that the patient passed the dangerous period smoothly, reducing perioperative mortality, and receiving good results. If intraoperative conditions did not allow, femoral vein bleeding treatment was performed. Postoperative hemodialysis treatment was feasible after the patient’s condition was stabilized. If necessary, plasma exchange was performed to remove large amounts of myoglobin.