Arteriosclerotic occlusive disease of the limbs is a series of signs and symptoms of ischemia in distal tissues and organs due to arterial stenosis or occlusion caused by atherosclerosis. Atherosclerotic lesions are a systemic disease that can occur in arteries throughout the body, mostly in large and medium-sized arteries, with the most common sites being the abdominal aorta, lower extremity arteries and carotid arteries, and are common in vascular surgery. If it occurs in the aorta and lower extremity arteries, it will cause coldness, numbness, intermittent claudication of the lower extremities, and in severe cases, foot pain and even ischemic necrosis, leading to amputation. The etiology of atherosclerosis is generally associated with hyperlipoproteinemia, hypertension, diabetes mellitus, obesity, smoking, low high-density protein, and advanced age. The course of the disease is generally divided into four stages according to the severity of the patient’s symptoms. Stage 1: Mild complaint stage. The affected limb is mildly numb or feels mildly cold or easily fatigued after activity. Phase 2: Intermittent claudication. When the patient walks a certain distance, pain in the lower extremity appears and is relieved after resting for a few minutes, and then can continue to walk almost the same distance. Phase III: Resting pain. Due to the severe ischemia of the distal lower extremity, the patient feels pain even at rest, especially at night due to the low blood pressure of the whole body which makes the pain very intense, and often sits with his feet in his arms and stays awake all night. Phase IV: Tissue necrosis phase. If the blood supply to the distal tissues of the lower limbs does not improve during the resting pain period and the sclero-occlusive disease develops further, ulceration or necrosis of the extremities may occur; sometimes even septic infection. At this stage, the pain is more intense and unbearable for the patient. When examining the patient’s limbs, only mild redness of the limb skin and little change in skin temperature can be found in the early stage; further development of the disease may result in pale limb skin, cold skin temperature and weak or even no pulsation of the limb arteries. In advanced stages, skin ulceration and necrosis of the limb may occur, and in severe cases, soft tissue such as muscle or/and bone necrosis may occur. Arterial ischemia causes foot necrosis in patients The diagnosis is usually not difficult based on the patient’s symptoms and signs, combined with age and ancillary examinations. Ancillary tests include Doppler ultrasound, CTA and arteriography. Doppler ultrasound is a non-invasive test, simple to operate and widely used, and can be used as a screening test for this disease. However, ultrasound examination is closely related to the clinical experience of the sonographer, and the vascular surgeon can only judge the disease based on the description of the ultrasound report, therefore, ultrasound examination is only a rough examination, and there is a certain error with the actual condition of the patient. When the disease is identified by ultrasonography and further quantification of the lesion is needed to clarify the degree, location and length of arterial stenosis or occlusion, CTA examination of the arteries is required to provide a more refined and accurate understanding of the arterial lesion and help the vascular surgeon to develop a specific treatment plan. Arterial occlusion detected by CTA examination Arteriography is an invasive examination and is less often used alone. It is mostly combined with treatment when arterial lesions are clearly identified by CTA examination and endovascular treatment is required, which can both reduce the patient’s pain and medical costs. Arteriography shows arterial occlusion The treatment of arteriosclerotic occlusive disease mainly includes general treatment, drug treatment and surgery. General treatment mainly includes strict lifelong smoking cessation, blood pressure control, weight loss and lipid lowering; keeping the affected limbs warm, preventing trauma, proper exercise, promoting the formation of collateral circulation and improving blood circulation; do not scald the affected feet to avoid aggravating the ischemia of the affected feet and scalding the affected feet. Drug treatment is mainly the application of anti-platelet drugs, such as enteric aspirin; vasodilator drugs, such as prostil, etc.; lipid-lowering drugs, etc. Surgical treatment mainly includes endarterectomy, autologous vascular bypass or artificial vascular bypass, vascular balloon dilation and stent implantation, etc. According to the patient’s specific condition, the vascular surgeon and the patient should work together to develop a specific surgical plan that is most suitable for the patient.