Acromegaly is a type of motor neuron disease (MND), medically known as amyotrophic lateral sclerosis (ALS). It is commonly known as “acromegaly” because it is characterized by progressive muscle atrophy and weakness, as if the body is gradually frozen. It is an incurable and fatal disease. Stephen? Stephen Hawking also has this disease. Patients often die within 3 to 5 years after the disease. The prevalence of ALS is 4-6 per 100,000, and the age of onset is 20-80 years old, with an average of 57 years old, and the number of male patients is twice that of female patients. “ALS is characterized by progressive degeneration of motor nerve cells in the brain and spinal cord. Since motor neurons control the activity of the muscles that enable us to move, speak, swallow and breathe, without nerve stimulation they will gradually atrophy and degenerate, manifesting as progressive muscle weakness and paralysis, as well as reduced speech, swallowing and respiratory function, until death from respiratory failure. The standard management of ALS consists of 3 main aspects: 1. Liruta is the only neuroprotective therapy that has been proven to be effective in slowing down the progression of the disease. 2. Invasive and non-invasive ventilator-assisted respiratory support; 3. Enteral nutritional support. ALS patients with dysphagia tend to eat very slowly, they have to keep their energy focused to avoid possible choking and choking, and calorie intake gradually lags behind consumption. A percutaneous gastrostomy is usually considered for nutritional supplementation when weight loss exceeds 10% of usual weight and body mass index is below 18.5 kg/m2. The American Academy of Neurology guidelines for the treatment of ALS recommend that a fistula be placed immediately after the onset of dysphagia. In addition, ALS patients with respiratory muscle weakness or medullary paralysis progress to respiratory failure, increasing the risk of aspiration due to food and saliva. Non-invasive ventilators or invasive ventilators after tracheotomy are required. Percutaneous gastrostomy can significantly reduce the risk of aspiration. Percutaneous endoscopic gastrostomy (PEG) and percutaneous fluoroscopic gastrostomy (PRG) are commonly performed, and PEG implantation involves the use of a gastroscope to access the stomach through the esophagus to observe the situation and requires general anesthesia. The American Academy of Neurology guidelines for the treatment of ALS recommend a forceful lung volume (FVC) greater than 50% at the time of PEG placement. A lower FVC index implies an increased anesthetic risk during PEG feeding tube implantation, mainly due to the fear of not being able to resume spontaneous breathing after general anesthetic intubation; and even if PEG is successful, the mortality rate within 1 month is as high as 8-10%. For patients with high mortality within 1 month of PEG and those with severe respiratory impairment (FVC <50%), a recent study by our interventional team found that percutaneous fluoroscopic gastrostomy (PRG) is feasible, and PRG does not require general anesthesia, but only local anesthesia without sedation, and can be a safe and effective method for this type of patients. PRG has been performed in dozens of patients with a 100% success rate, and is currently well tolerated by patients with no serious complications and a mortality rate of 0 in 1 month. PRG has brought a boon to these acromegaly patients who have been turned back by many major hospitals due to poor respiratory function. The main indications include malnutrition caused by difficulties in eating through the mouth for various reasons, while the gastrointestinal tract functions normally and requires long-term nutritional supporters. It is especially suitable for the following cases: 1, various neurological diseases and systemic diseases caused by the inability to swallow, with or without aspiration respiratory infection; 2, esophageal lesions caused by stenosis, head and neck tumors and the hypopharynx and esophagus caused by feeding difficulties; 3, malignant tumors caused by cachexia and anorexia, need to supplement nutrition via the gastrointestinal tract.