TASC D lesions (chronic occlusions longer than 20 cm) have been considered off-limits for interventional treatment, but our summary of previous experience shows that a large proportion of TASC D lesions can be completely opened by interventional techniques. We summarized 24 previous TASC D lesions, of which 20 were successfully opened. TASC D lesions should not be excluded from interventional treatment in general. A typical case: Gao*, male, 60 years old, retired teacher. 4 years ago, he went to the local hospital for sudden intermittent claudication of the left leg and found thrombotic occlusion of the left femoral N artery, at that time, he underwent thrombectomy, but the symptoms of the left leg did not improve, but worsened, and he had to stop to rest after walking one or two hundred meters. The left femoral N artery artificial vessel bypass surgery, the blood through the artificial vessel to the distal end of the left leg, and the own lower limb artery abandoned. After two surgeries, the symptoms of intermittent claudication in his left leg improved slightly, but he could only walk about 500 meters before he had to take a break. This year, the pain and coldness in his left leg suddenly worsened again, and he went to the local hospital and found that the artificial blood vessel bridge was occluded, and the catheter thrombolysis was unsuccessful. Old Gao came to our vascular surgery department for consultation. After carefully studying the CTA of his lower extremity artery, we thought that the artificial vessel bridge had no chance to open again, but the occluded section of the autologous artery, although more than 40 cm long, still had a chance to be opened through interventional molding and stent implantation to restore the blood supply to the left lower extremity. After careful preparation and an interventional reconstruction procedure lasting more than 3 hours, Lao Gao’s 4-year-old occluded left lower extremity autologous artery was finally opened completely. The skin temperature of the left foot and the pulsation of the dorsalis pedis artery returned to normal, and the symptoms of intermittent claudication completely disappeared.
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