Abstract
What's New?: This study introduces a novel, periosteum-preserving iliac crest transverse transport (ICTT) technique for high-level lower extremity arteriosclerosis obliterans (LEASO), targeting patients unsuitable for conventional revascularization.Technical Innovation: By relocating the osteotomy from the weight-bearing tibia to the non-weight-bearing ilium, this minimally invasive technique eliminates the risk of stress fractures, allows for immediate full weight-bearing, and expands indications to patients with proximal arterial occlusions.Clinical Efficacy: The procedure proved highly effective, resulting in significant ischemic pain relief, a measurable increase in distal limb perfusion, and a 100% healing rate for all chronic ulcers and non-healing amputation stumps.Key Finding: ICTT appears to be a safe and potent biological intervention that addresses the critical issue of microvascular dysfunction in LEASO, offering a promising new limb salvage strategy with no major complications observed.