The diagnostic and therapeutic paradigm for lower extremity arteriosclerosis obliterans (ASO) is undergoing a fundamental shift from conventional morphology-based assessment toward functional evaluation and predictive medicine. Numerical simulation techniques that integrate computational fluid dynamics (CFD) and finite element analysis (FEA), grounded in patient-specific imaging data, have emerged as a central driving force of this transformation. This review systematically elucidates how these approaches enable the construction of vascular “digital twins” to achieve precise quantification of the hemodynamic environment associated with ASO lesions, virtual monitoring of disease progression, and preoperative optimization of therapeutic strategies. Particular emphasis is placed on the critical role of numerical simulation in supporting clinical decision-making, such as evaluating the necessity of interventional treatment and predicting the mechanical responses of endovascular devices. Furthermore, the potential, current challenges, and future directions of numerical simulation in advancing personalized and precision management of ASO are comprehensively discussed.
ObjectiveTo evaluate the value and experience of the multidisciplinary team (MDT) approach in the management of patients with lower extremity arteriosclerosis obliterans (ASO). MethodsA retrospective analysis was conducted on 46 consecutive patients with lower extremity ASO who were treated with MDT model at Zhongshan Hospital, Fudan University, from May 2021 to April 2024. All subjects had critical limb ischemia (Rutherford category ≥4) with comorbidities involving two or more organ systems. Overall mortality, above-ankle amputation rate, and below-ankle amputation rate were recorded. The frequency and depth of involvement of each specialty in the MDT process were also documented. ResultsOf the 46 patients, 37 were male and 9 were female, with a age of (74.3±11.8) years. Major comorbidities included heart disease, hypertension, cerebrovascular disease, diabetes, chronic kidney disease, hyperlipidemia, and others. Overall mortality was 13.0% (6/46). The total amputation rate was 32.6% (15/46), comprising above-ankle amputation in 19.6% (9/46) and below-ankle amputation in 13.0% (6/46). Fourteen disciplines participated in the MDT; in addition to vascular surgery, the most actively involved departments were endocrinology, cardiology, and nephrology. ConclusionsThe MDT model offers unique advantages in the management of critical lower-extremity ASO. By coordinating revascularization timing, extent, and modality, prioritizing comorbid conditions, tailoring operative plans, and optimizing perioperative support, the MDT approach reduces mortality, improves limb salvage rate, and enhances both prognosis and quality of life.