Acute infrarenal abdominal aortic embolism is one of the acute and serious diseases in vascular surgery. With its sudden onset, rapid progression, obvious symptoms, high mortality and amputation rates, it is known as a catastrophic disease in vascular surgery. Although this disease is not common, but in recent years there is a trend of increase, so early diagnosis and active and reasonable treatment is very important. 1, diagnosis Acute renal artery embolization of the lower abdominal aorta patients often have organic heart disease, atherosclerosis, atrial fibrillation history, atrial fibrillation is more common. Such high-risk patients once acute pain in both lower limbs, dorsalis pedis arterial pulsation disappearance, numbness, dyskinesia and lower skin temperature and other clinical manifestations should be thought of this disease, acute multispectral color ultrasound preliminary examination. 2.Treatment Once diagnosed, the disease is immediately anticoagulated, thrombolytic therapy to prevent the spread of thrombus and secondary thrombosis of distal arteries, while emergency surgery to restore blood flow as soon as possible to save the limb. Abdominal aortic embolism distal ischemia time is closely related to the occurrence of myorenal metabolic syndrome and osteofascial compartment syndrome; the golden time for treatment is within 12h of the onset of the disease, and the amputation rate and mortality rate will increase significantly if it exceeds. Surgical treatment is preferred to Fogarty catheter thrombolysis via bilateral femoral artery incision. Into the abdomen through the abdominal aorta or iliac artery thrombolysis, traumatic, on the respiratory and circulatory function of the impact of large, increased complications, and is not advocated; only when the bilateral femoral artery Fogarty catheter thrombolysis proximal jet of blood is not good, or the combination of abdominal organs vascular embolism is carried out. Within 12 h of the onset of the disease, try to consider limb-preserving embolization, and closely observe the occurrence of osteofascial compartment syndrome after the operation and promptly manage it. For patients with the possibility of osteofascial compartment syndrome, a positive attitude can be taken to prevent the incision of osteofascial decompression. Surgery strives for simplicity and aims to restore blood flow, and extra-anatomic bypasses such as axillary-femoral bypass can be used as one of the alternatives. Anticoagulation and thrombolytic therapy are suitable for perioperative and critical conditions, comorbidities, and patients who cannot tolerate surgery; recently, some scholars have also taken a more positive attitude towards anticoagulation and thrombolytic therapy for such patients, and consider it safe and effective. 3, postoperative complications, cause of death analysis and countermeasures Due to acute renal artery embolism of the inferior abdominal aorta in the development of the disease, muscle ischemia, hypoxia and blood flow recovery after reperfusion injury, the resulting myoglobin, hyperglycemia, oxygen free radicals, and other acid metabolic toxins, which can lead to necrosis of the limb, myo-renal metabolic syndrome, osteo-myofascial compartment syndrome, cardiac failure, ARDS. acute lower limb The incidence of ischemia-reperfusion injury after recanalization of arterial embolism reaches 58%, peaks at 12 h, and patients mostly die within this time frame. In the case of ensuring cardiac function, intraoperative and postoperative infusion of 5% sodium bicarbonate, correct electrolyte disorders, metabolic acidosis, alkalinization of urine, accelerate the discharge of myoglobin from the urine, reduce the incidence of acute renal failure; high-dose glucocorticoids have a certain effect on the stabilization of cellular metabolism; in the maintenance of effective circulatory and electrolyte balance, cardiac tonicity, diuresis, which can reduce the cardiac load, and is conducive to the excretion of toxic products in vivo. Excretion. Under the condition, the patients with renal insufficiency can be supplemented with intraoperative bedside continuous renal replacement dialysis treatment, which can significantly reduce the mortality rate; after removing the embolus, intermittent opening of distal blood vessels, opening the arterial vasculature and blocking the proximal femoral vein at the same time, and puncture and release appropriate amount of venous regurgitation to reduce the reflux of metabolic wastes, which can also reduce the occurrence of the complications of myorenal and renal metabolic syndromes and other complications. Continuous postoperative anticoagulation reduces the risk of recurrence of reembolization.