The majority of patients with Peripheral Artery Disease (PAD) have limited mobility and ambulation, resulting in decreased physical function and quality of life.PAD is caused by atherosclerosis resulting in narrowing or occlusion of the arteries, which affects the blood supply to the lower extremities and results in symptoms.The classic symptom in patients with PAD is intermittent claudication (limp): Activity causes reversible muscle discomfort in the lower extremities, which can be recovered after about 10 minutes of rest. This discomfort manifests as muscle fatigue, pain or cramping with activity and is relieved by rest. Symptoms are most often seen in the lower legs, but can also accumulate to the thighs and buttocks. This group of patients is clinically referred to as, intermittent claudication (intermittent claudication). Critical Limb Ischemia (CLI) is a manifestation of peripheral arterial disease in which the patient has typical chronic ischemic resting pain or ischemic skin lesions such as ulcers or gangrene. the concept of CLI can only be applied to patients with chronic ischemic disease, i.e., patients with ischemic symptoms lasting more than 2 weeks. Antiplatelet agents in vascular surgery: ① Antiplatelet agents are effective in preventing thrombotic events in patients with PAD The treatment strategy varies for different types of patients with lower extremity ischemia. In patients with intermittent claudication, drug therapy with aspirin or clobigrel alone does not improve walking distance. However, because patients with PAD often have a combination of cardiovascular and cerebrovascular pathology or the presence of corresponding risk factors, such as smoking, hyperlipidemia, hyperglycemia and hypertension. Antiplatelet therapy can effectively reduce the occurrence of cardiovascular and cerebrovascular events, and is a routine drug for primary and secondary prevention. Clopidogrel (Bolivar) is increasingly used. As a third-generation antiplatelet drug, it is considered more effective in preventing cardiovascular and cerebrovascular events in patients with atherosclerosis. Studies have shown that clopidogrel (75 mg/d) has a slight advantage over aspirin (325 mg/d) in reducing the risk of infarction, stroke, and cardiovascular death (5.32% vs. 5.83%).The CURE trial confirmed the long-term use of clopidogrel (first dose of 300 mg, 75 mg/d) in addition to aspirin in patients with non-ST-segment elevation acute coronary The CURE trial confirmed the safety and efficacy of clopidogrel (first dose of 300 mg, 75 mg/d) in the long-term management of non-ST-segment elevation acute coronary syndrome (ACS) patients. Moreover, the combination of the two has become the standard of care for one month after coronary stenting. The recent CREDO trial demonstrated that long-term use of clopidogrel (1 year) was effective in reducing ischemic events after percutaneous coronary angioplasty (PCI). Cilostazol, an inhibitor of phosphodiesterase III, has vasodilating, metabolic modulating and antiplatelet effects. a meta-analysis of 6 randomized controlled clinical trials demonstrated that cilostazol significantly improved maximal pedal exercise capacity and prolonged interstitial claudication distance compared with placebo. ② Antiplatelet agents are effective in improving patency after revascularization Although long-term aspirin and clopidogrel therapy decreases the progression of atherosclerosis and reduces the risk of cardiac, cerebral, and peripheral vascular events in all patients with PAD, there is still no evidence that these agents improve patient outcomes in patients with severe lower extremity ischemia. Studying the CLI population is difficult because a significant number of patients die in longitudinal studies, resulting in incomplete data and unreliable results. Various forms of revascularization (vascular bypass, balloon dilation, stenting) are effective treatments for lower extremity ischemia. Regarding the role of aspirin after vascular bypass, several trials have demonstrated that the application of aspirin improves the long-term patency of bypass vessels and decreases the rate of secondary surgery in bypass vessels. The dose-effect relationship of aspirin is still not completely clear, but from the observation of long-term clinical trials, 75-150 mg/day is the optimal dose that is relatively effective with relatively little risk of gastrointestinal discomfort reactions and bleeding.