Acute lower limb arterial embolism is a vascular surgical emergency with rapid onset and even life threatening limbs. Our hospital has treated 42 patients with Fogarty balloon catheter since 1992, and combined with the comprehensive treatment method of intraoperative and postoperative anticoagulant drugs to achieve good therapeutic results. 1. Clinical data: 1.1 General information: 42 patients, 29 males and 13 females, minimum age 19 years, maximum age 88 years, average age 58.2 years, 5 patients came to our hospital within 8 hours after the onset of the disease, 20 patients came to our hospital 8-24 hours after the onset of the disease, and 17 patients more than 24 hours. 8 hours patients did not show gangrene of the limb, 8-24 hours patients There were 6 cases of gangrene in the limbs, and 9 cases of gangrene in the limbs of patients seen after 24 hours. Acute lower extremity arterial embolism site: Department Number of cases % Abdominal aorta transverse embolism 5 11.9 Iliac artery 10 23.8 Femoral artery 17 40.5 N artery 8 19.1 Below N artery 2 4.7 Total 42 100.00 Patients’ clinical manifestations were: sudden unilateral lower extremity pain, numbness, decreased skin temperature, pale or bruised skin limbs, loss of N artery, dorsalis pedis artery and posterior tibial artery in the affected extremity, 8 cases The patients were diagnosed clearly by color Doppler before surgery. 1.2 Treatment: All patients were treated with arterial embolization by Forgarty balloon catheter. Using continuous epidural block anesthesia, a longitudinal incision was made at the affected femoral triangle to reveal the femoral artery, and a transverse incision was made in the femoral artery, and the catheter was slowly pulled out after 25-30 cm insertion in the proximal and distal femoral artery, and the operation was repeated several times until there was high pressure blood flow ejected from the proximal end and richer reflux blood in the distal end. Heparin saline was injected into the distal Rui artery to flush and inject urokinase 200,000 u. 4-0 prolene suture was continuously sutured to the arterial incision, and urokinase 400,000 u/d, low molecular heparin 0.8/d or heparin 5000 u/d were routinely given postoperatively. 2. Results 42 patients were operated on, no perioperative death, 22 limbs recovered well after surgery; 3 cases were re-embolized during the perioperative period, and all were performed again Forgarty catheter embolization; 2 patients without gangrene at the time of consultation underwent postoperative limb amputation; 2 of 17 patients with different degrees of gangrene before surgery did not undergo limb amputation, and the rest underwent different degrees of limb amputation; 2 patients with reperfusion injury-induced calf fascial septal syndrome after surgery were given fascial decompression, and the limbs recovered well after surgery. 3.Discussion Acute lower limb arterial embolism is an acute ischemic lesion in the lower limb caused by the blockage of the arterial lumen due to the flow of blood to the distal artery by thrombus or plaque originating from the heart or arterial detachment. It can occur in any age group, but it is more common in patients over 50 years old. Patients often have combined cardiovascular pathologies, such as wind heart, coronary heart, atrial fibrillation, subacute endocarditis, arteriosclerosis and aortic aneurysm, etc. Their clinical signs are not consistent, and early diagnosis and corresponding therapeutic measures are the key to successful treatment. 3.1 Diagnosis Patients with sudden onset of severe limb ischemic signs, disappearance of the corresponding arterial booting, pulselessness (Pulselessness), pain (Pain), pallor (Pallor), sensory abnormalities (Paresthesia), and dyskinesia (Paralysis), with organic heart disease, atherosclerosis, and especially with atrial fibrillation. The diagnosis is not difficult in patients with recent myocardial infarction or aortic aneurysm. The key to the diagnosis of acute lower extremity arterial embolism is to further define the part of the embolism: the plane of the embolism can usually be accurately determined by physical examination, which is mainly based on the disappearance of the corresponding arterial movement of the limb, as well as the plane of skin temperature and skin color changes. For example, the embolism of common femoral artery shows the decrease of skin temperature below the lower thigh of the affected limb and the change of skin color starts from the lower middle of the calf. If the diagnosis is in doubt, auxiliary examination methods can be used: 1. color Doppler examination: it can accurately determine the site of arterial embolism, and can also detect unknown thrombus in the venous system; 2. arterial angiography: it is the most accurate method to determine the thrombus, but it is invasive and only feasible after stable condition and adequate anticoagulation treatment. If the diagnosis is clear, this test is generally not available. 3.2 Treatment 1. Non-surgical treatment All acute arterial embolism, regardless of whether surgical treatment is performed, should be treated with non-surgical treatment first. Non-surgical treatment is the preoperative and postoperative adjuvant treatment, only when the patient’s condition is critical and cannot tolerate surgery; smaller arterial embolism, good compensation of collateral circulation; long time of arterial embolism, gangrene has appeared in the distal limb, etc., then only non-surgical treatment is performed. Commonly used non-surgical treatment methods include: appropriate body position, anticoagulation, dispel aggregation, thrombolysis, antispasmodic, vasodilatation, hyperbaric oxygen and Chinese herbal medicine. 2.Surgical treatment Lower limb artery embolism used to mainly use artery incision, catheter negative pressure suction and thrombus endothelial dissection. Since 1992, our hospital has adopted the comprehensive treatment method of removing embolism by Fogarty catheter through femoral artery and injecting drugs such as urinary hormone enzyme into the distal end of embolized vessel with broken Fogarty catheter, which has achieved satisfactory efficacy. The prognosis of acute arterial embolism is closely related to the time of receiving regular treatment. Yuan Chao et al. reported that no death occurred within 12 hours of receiving surgery, and the amputation rate was 3%. In this group, the cure rate of arterial embolism treated within 8 hours is 100%, but most of the cases are admitted to hospital for more than 8 hours. The reasons for the delay in treatment are mainly related to the delay in consultation by the patients themselves and the lack of understanding of the disease by the medical personnel of the primary unit, and the misdiagnosis or blind thrombolysis delaying the timely surgery, resulting in further aggravation of the disease. We believe that acute lower extremity arterial embolism should be actively treated surgically, and the embolism should be removed before the jaundice of the limb occurs. Embolization can only remove the arterial trunk thrombus, and if the patient has swelling of the foot or limb when the venous return is obstructed, the postoperative effect is poor. However, the improvement of blood supply after embolization can effectively reduce the amputation surface, and the amputation stump may heal in one stage. Intraoperative and postoperative treatment with anticoagulation and thrombolysis can effectively improve the limb survival rate.