ObjectiveTo evaluate the value and experience of a multi-disciplinary team (MDT) approach in the management of patients with lower extremity arteriosclerosis obliterans (ASO). MethodsA retrospective analysis was conducted of 46 consecutive patients with 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 grade 4 or more) and at least one major organ dysfunction. 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 (80.4 %) were male and 9 (19.6 %) were female, with a mean age of (74.33±11.8) years. Major comorbidities included diabetes mellitus in 40 cases, cardiac disease in 30, hypertension in 31, renal insufficiency in 22, prior cerebral infarction in 14, and chronic obstructive pulmonary disease in 11. Overall mortality was 13.04% (6/46). The total amputation rate was 32.61% (15/46), comprising above-ankle amputation in 19.57% (9/46) and below-ankle amputation in 13.04% (6/46). Seventeen disciplines participated in the MDT; in addition to vascular surgery, the most actively involved departments were endocrinology, cardiology, and nephrology. ConclusionThe 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 peri-operative support, the MDT approach reduces mortality, improves limb-salvage rates, and enhances both prognosis and quality of life.
