Interventional therapy (stenting) has become one of the main means of treating lower extremity atherosclerosis, and many patients think that having stenting surgery is a “safe deposit box” and that they are done for good. However, there are some patients who suffer from restenosis or occlusion of the leg arteries after surgery, some of which are due to failure to take medication as required by the doctor, some are due to the progression of the disease itself (diabetes, atherosclerosis, hyperlipidemia, etc.), and some are due to uncorrected bad habits (such as smoking). The prevention of recurrence after surgery should not be neglected. Adhering to the use of antiplatelet drugs, controlling high blood sugar, high blood pressure, high blood lipids, and abandoning bad habits (smoking cessation) are all important aspects to reduce the risk of recurrence. As we age, everyone’s blood vessels slowly become “old”: initially, it is often manifested as “atherosclerosis”, which is a progressive systemic disease that often does not cause significant discomfort at this time, when atherosclerosis occurs in the blood vessels supplying the heart – the coronary arteries and When atherosclerosis occurs in the coronary artery, the blood vessel supplying the heart, and blocks the blood vessel, it is what we usually call “coronary heart disease”; similarly, when it occurs in the artery of the leg, causing the narrowing or occlusion of the blood vessel, it is called lower extremity atherosclerosis occlusive disease. Lower limb arteriosclerosis occlusive disease often does not attract people’s attention, in fact, lower limb arteriosclerosis occlusive disease is a serious danger to human health, often leading to amputation or death of the patient. With the development of society, the continuous improvement of people’s living standard, the change of diet structure, the progress of population aging, and the continuous development of vascular surgery treatment level, the incidence of atherosclerosis-occlusive disease in China has an increasing trend. A population survey conducted by foreign vascular research centers shows that 20% of symptomatic lower limb atherosclerosis occlusive disease suffer from diabetes, and compared with non-sugar shit patients, have a higher prevalence of lower limb atherosclerosis occlusive disease, the disease age is small, the course of the disease progresses quickly, smoking is extremely harmful to peripheral vessels, twice as much as cardiovascular and cerebrovascular. A survey in the United States found that 80% of patients with lower extremity atherosclerosis-occlusive disease smoked, and that smoking cessation could improve clinical symptoms and slow down the progression of the disease. Hypertension, hyperlipidemia, and obesity are also causative factors of PDA in lower extremity atherosclerosis-occlusive disease. Atherosclerosis is the result of the long-term combined effect of multiple pathogenic factors. Numerous epidemiological data and laboratory studies have shown that high blood cholesterol, hypertension and smoking are the main pathogenic factors for atherosclerosis in the elderly. People with major risk factors have a much higher incidence of atherosclerosis and morbidity and mortality compared to those without these factors. In addition, low physical activity, overweight, diabetes, mental stress, type A personality, and family history can influence the incidence of atherosclerosis and can lead to an earlier age of onset. Generally speaking, medication is the basis for the treatment of atherosclerosis. If the symptoms are not obvious and the narrowing of blood vessels is not serious, treatment with medication can be given first. However, if the narrowing of blood vessels is serious, drug treatment alone is not enough. However, if the stenosis is severe, medication alone is not enough, because medication can only slow down the process of slowly narrowing the blood vessels, but the narrowing of the arteries cannot disappear automatically through medication. Interventional treatment, also known as arterial stenting, is a mechanical method of eliminating the stenosis, thereby restoring blood supply to the ischemic limb. Stenting procedure and postoperative maintenance: The early stage of lower extremity atherosclerosis occlusive disease has no characteristic manifestations, which can be discomfort such as leg numbness and weakness. The presence or absence of lower extremity atherosclerosis occlusive disease symptoms and their severity are influenced by the speed of lesion progression, the number of collateral circulation, individual tolerance and other factors, and the diagnosis of lower extremity atherosclerosis occlusive disease solely relying on clinical lower extremity atherosclerosis occlusive disease performance is easy to miss diagnosis and treatment, and the maneuverability is poor. For example, in patients with lower extremity atherosclerosis occlusive disease combined with diabetes, due to the dullness of sensation in patients with lower extremity atherosclerosis occlusive disease of the nervous system, some patients with lower extremity atherosclerosis occlusive disease have severe deficiency of blood supply to the lower extremity arteries, but the clinical symptoms are mild or even lacking. for people over 60 years old, it is recommended to check the lower extremity arterial vascular ultrasound during physical examination in order to detect arterial vascular disease in the legs in a timely manner. Symptoms in the middle stage of lower limb arteriosclerosis-occlusive disease are intermittent claudication, diminished or absent distal arterial pulsation, and cold and numb feet. In the late stage of lower limb arteriosclerosis-occlusive disease, resting pain, significantly lower skin temperature, cyanosis, toe end ulcers, and gangrene may occur. Once these symptoms appear, you should urgently go to the hospital to see a doctor. Atherosclerosis can occur in any part of the body, and if care is not taken to eliminate the underlying risk factors that lead to atherosclerosis, blockage of blood vessels in other locations may still occur. Therefore, good or bad “maintenance” after surgery directly affects the health of the patient after stenting. After stent surgery, I feel that my fever has subsided, my steps have been taken, and the pain in my legs and feet is gone. However, stent surgery only solves the problem of blood vessels in the leg, if hypertension, hyperlipidemia and hyperglycemia still exist, they will also cause damage to the inner wall of blood vessels, just like a river blocked by silt, removing silt and dredging the river can only solve the urgent problem, planting trees and controlling soil erosion is the fundamental solution. Therefore, patients with hypertension, hyperlipidemia and diabetes need to insist on long-term antihypertensive drugs, lipid-lowering drugs and glucose-lowering drugs after stenting. Precautions after stenting 1. Regular review Patients need to be reviewed regularly after surgery. The doctor can decide whether to adjust the dosage and type of medication according to the arterial patency to achieve the best efficacy. In addition, if you feel that some symptoms similar to those before surgery appear again after surgery, please do not ignore them and should go to the hospital to see the doctor as soon as possible. Patients should insist on regular follow-ups. Follow-up after surgical treatment is especially important, and patients should be instructed to adhere to regular, scheduled follow-up. After discharge from the hospital, they should visit the outpatient clinic at the time points of 1 month, 3 months, 6 months, 9 months, and 1 year to receive follow-up examinations. Patients over 40 years of age should insist on annual testing of blood lipids, blood pressure, liver and kidney function, lung X-ray, and electrocardiogram. 2. Medication use Patients should adhere to long-term regular medication (anti-platelet drugs, antihypertensive drugs, lipid-lowering drugs, glucose-lowering drugs). The purpose of taking anti-platelet drugs (aspirin, poliovirus, cilostazol, etc.) is to: prevent the blood from becoming sticky and prevent clots from forming in the blood vessels. The stent implanted in your body does ensure that this section of your blood vessel is not narrowed for a period of time, but at the same time there is inevitably a slight damage to the endothelium of the vessel. The damaged endothelium grows back along the stent. At this point, the platelets start to help again, and a large group of platelets will build up and form another clot in the damaged area, which may block the vessel again. That’s why we must use anti-platelet drugs to prevent this from happening. For the first three months, take aspirin and Bolivar or cilostazol, and later you can use aspirin alone. There is evidence that cilostazol has significantly improved symptoms and prevented restenosis in lower limb atherosclerosis, and can be taken for a long time. 3, moderate exercise Post-stenting patient exercise should master the intensity of exercise, the most practical indicator reflecting the size of exercise intensity is the heart rate. Calculation formula: 170 – age = the fastest heart rate per minute limit when you exercise. For example, if the age is 65, 105 beats per minute is the upper limit, and patients must keep their heart rate within the limit. Walking is a very suitable form of exercise for middle-aged and elderly people. You can walk for 45-60 minutes at a time or 1000-2000 meters a day, with even stride, stable gait and natural breathing to prevent falls. For some patients with lower extremity atherosclerosis occlusive disease, although the symptoms have improved after stenting, walking time is still not long, which requires a gradual, slow, tired rest will then walk. You can also do leg lifting and lowering while sitting or lying down to exercise the lateral branch circulation on the legs. Other exercise programs are taijiquan, gymnastics and qigong, etc., can be selected according to the specific circumstances. 4.Healthy life A healthy life helps patients control blood pressure, blood lipids and blood sugar, which is conducive to the repair of the good condition of the whole body, thus laying a solid foundation for the successful treatment of patients, including reasonable diet, moderate exercise, smoking cessation and alcohol restriction, and psychological balance. Other things are regular living and avoiding staying up late. Diabetic patients, lower limb atherosclerosis winter patients winter foot soak water temperature should not be too high, may aggravate the foot ischemia or even scalding.