Clinical Efficacy of Periosteum‐Preserving Iliac Crest Transverse Transport for Symptomatic High‐Level Lower Extremity Arteriosclerosis Obliterans

Summary 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.