Recently, our department successfully performed lower extremity arteriotomy for thrombosis with the assistance of DSA (digital subtraction angiography) to save a patient with extensive thrombosis in the lower extremity arteries, and successfully saved the patient’s limbs. The patient was an elderly male, 77 years old, with poor physical condition and severe emphysema in the past. He was treated at a local hospital for sudden onset of coldness and pain in the right lower extremity. Both ultrasound and CTA (CT angiography) of the lower extremity arteries indicated extensive thrombosis of the lower extremity arteries, and he was given infusion therapy, which was not effective. Based on the ultrasound and CTA examination results, we judged the complexity and severity of the disease, and had a detailed communication with the patient’s family. The patient had extensive thrombosis in the right lower limb artery, which had been blocked for a long time, and there was a serious atherosclerotic plaque a few centimeters up from the root of the thigh, which made the operation more difficult and risky, and the condition was heavy and the amputation rate was high. Finally, the patient’s family requested emergency surgery with the idea of fighting. In order to improve the accuracy and certainty of the arterial thrombus retrieval, we chose to perform the procedure in the interventional catheterization room, that is, to deliver the thrombus retrieval catheter into the obstructed artery under X-ray fluoroscopy, and the trajectory of the catheter was always under our monitoring and control, and then the balloon at the front end was inflated after the catheter was in place to drag the thrombus out of the vessel. This operation provides a powerful safeguard to improve the precision of the procedure and prevent the catheter from accidentally entering the arterial branches. The patient had a history of emphysema and low oxygen saturation, so we performed the procedure under local anesthesia to avoid interference with the patient’s respiratory function. A 5-cm-long incision was first made at the root of the right thigh, and the femoral artery was fully exposed by incision layer by layer. After several attempts to pass the guidewire and catheter through the plaque and into the true lumen of the artery under X-ray surveillance, we removed a large amount of old thrombus and placed a vascular stent at the calcified plaque, which relieved the severe local stenosis, and by this time, the proximal artery had resumed pulsation and blood was ejected from the incision. Next, we blocked the proximal artery and sent the guidewire and catheter into the distal artery, but the delivery to the knee joint was again blocked, considering that it was related to the longer and harder thrombus. The operation was declared a success. In less than an hour after the operation, the cold, cyanotic right leg was warm and rosy again, which was an immediate effect and made us and the patient’s family feel very happy. In the past, the arteriotomy to retrieve the embolus was performed in the operating room, and there was a certain blindness in the retrieval of the embolus, and the effect could not be guaranteed, but now with the help of the DSA imaging machine, we are like a fish in water and a tiger with wings, which obviously improves the accuracy of the operation and ensures a good result. We sincerely hope that the improvement of medical equipment and medical standards will bring more patients the gospel. We would like to remind all patients that as the weather turns cooler, patients with lower limb arterial ischemia will experience an increase in symptoms. If middle-aged or elderly patients have a history of diabetes, hypertension, hyperlipidemia and smoking, and suddenly experience coldness and pain in the lower limbs or sudden aggravation of the above symptoms, they should consider the possibility of acute lower limb arterial ischemia, and it is recommended to immediately go to a regular hospital for vascular ultrasound examination to make a clear diagnosis and avoid delaying It is recommended to go to a regular hospital immediately for vascular ultrasound examination to make a clear diagnosis and avoid serious consequences such as toe amputation and amputation due to delayed treatment.