From Xinmin Evening News: Recently, Mr. Xu, who had been troubled by dizziness for half a year, came to the neurosurgery department of Shanghai Tongji Hospital and was seen by Dr. Zhang Guiyun, who inquired about his medical history and did a physical examination and found that the patient had “pulselessness of the radial arteries of both upper limbs. ”Pulselessness” is a common clinical sign of peripheral vascular disease, due to incomplete obstruction, stenosis, spasm of the arteries and external pressure on the vessels, which affects the smooth flow of blood, resulting in significant weakening or disappearance of the arterial pulse, causing pain in the patient’s limbs, decreased skin temperature, pale, dry skin, and impaired peripheral nutrition of the limbs. When patients develop intermittent claudication, it often suggests the possibility of chronic arterial obstruction. Intermittent claudication means that the patient has no obvious discomfort when he or she is not walking, but as soon as he or she walks the diseased lower extremity becomes sore and uncomfortable, so that he or she has to stop and rest, and after a period of rest this discomfort disappears and he or she can continue walking again. If there is a sudden onset of severe pain, decreased skin temperature, pallor, or even numbness in the limb, it often indicates acute obstruction of the limb artery, mostly arterial embolism or acute thrombosis. Patients with pulselessness often feel cold extremities and wear more clothes than others but do not feel warm. In order to further clarify the cause, the doctor suggested that Mr. Xu be hospitalized and then undergo a cerebral angiography (DSA) examination. It turned out that Mr. Xu’s left carotid artery had developed ulcerative plaque and the right carotid artery had developed severe stenosis, while his right subclavian artery was extremely narrow and the left subclavian artery was completely occluded. The examination results were completely consistent with the patient’s previous symptoms and signs. After full communication with the patient and his family, the medical team decided to implement an interventional treatment plan for Mr. Xu in two stages for all lesions. First, “balloon dilation + stenting” was performed on the left carotid artery with ulcerative plaque and the right subclavian artery with extreme stenosis, “balloon dilation + stenting” was performed on the right carotid artery with stenosis in the second stage, and “opening + stenting” was performed on the left subclavian artery with occlusion. The second stage was “balloon dilation + stenting of the right carotid artery stenosis” and “opening + stenting of the left subclavian artery”. The operation progressed smoothly, and the dizziness that plagued Mr. Xu was finally relieved, the radial artery pulsation that disappeared returned to normal, and the two cold hands were warm as before. With the continuous improvement of interventional technology and the expansion of clinical thinking of neurointerventional doctors, more and more previously untreatable diseases can now be treated with good results. Dr. Zhang Guiyun reminded the public that the consequences of subclavian artery occlusion not only affect the blood supply of the upper limbs, but can also cause subclavian artery steal syndrome, which seriously affects the blood supply of the brainstem, cerebellum and occipital lobe of the posterior circulation and requires early diagnosis and treatment.