In people’s minds, “vasculitis” is scary and often considered a sign of “amputation”. However, the truth is that there are many misconceptions about “vasculitis”. Many patients who come to our vascular surgery clinic with “vasculitis” are not vasculitis, but lower extremity varicose veins, lower extremity deep vein valve insufficiency, or deep vein thrombosis, and some elderly patients have “vasculitis” similar to intermittent claudication, Some elderly patients have intermittent claudication and rest pain similar to “vasculitis”, but they are suffering from lower limb atherosclerosis occlusive disease, and not “vasculitis”. So, what exactly is “vasculitis”? Can it be operated? The medical term “vasculitis” is actually the abbreviation for “thrombo-occlusive vasculitis (TAO)”. It is a chronic occlusive disease of the middle and small arteries of the extremities, and its pathological changes are segmental, non-suppurative inflammation of the walls of the middle and small arteries, resulting in thrombus formation in the lumen of the arteries, lumen occlusion, causing distal limb ischemia. The disease has certain geographical distribution characteristics, i.e., the incidence is higher in residents of cold and wet areas. Pain is the main symptom of the disease, with “intermittent claudication” in the early stage, but unlike the common atherosclerotic occlusive disease in the elderly, the symptoms are mostly concentrated in the lower leg or foot; resting pain and dry gangrene of the distal limb may appear in the later stage. The course of TAO is mostly more rapidly developed than that of atherosclerotic occlusive disease, and sometimes the location of the arterial lesion is higher and there is no good collateral circulation, which can easily cause necrosis of the toe or even the calf, and the conservative treatment is not effective, so the possibility of amputation is also higher. So, can vasculitis be treated by surgery? The goal of surgery for TAO is to improve the blood supply to the lower extremities and save as many limbs as possible. Depending on the disease, traditional surgical procedures such as lumbar sympathectomy, arterial bypass surgery, embolization and endarterectomy, and arterialization of lower extremity veins can be chosen, but the results of these procedures are limited due to the characteristics of the disease itself. Advances in interventional therapy have provided new treatment options. In recent years, we in the Department of Vascular Surgery of Zhongshan Hospital have been exploring and practicing the combined application of interventional techniques such as balloon dilation, stenting, and placement of thrombolysis in some TAO patients, and have achieved certain efficacy. From an overall perspective, the treatment effect of TAO is not very satisfactory, and combined drug therapy is essential. It is especially important to point out that once there are signs of TAO, one should immediately go to a regular hospital to avoid delaying the valuable treatment time. After diagnosis, the first priority is to quit smoking, even “second-hand smoke” should be eliminated, and at the same time, warmth, cold, trauma prevention, and active exercise to promote the formation of the lateral circulation of the limb.