Objective To compare the effects of DSA-guided Fogarty balloon catheter removal and incision exploration in the treatment of arterial crisis combined with thrombosis. Methods Analysis rstrospectively the clinical data of 35 cases who had vascular crisis after replantation of severed limbs and diagnosed with combined thrombosis by high-frequency ultrasound from September 2012 to May 2020 in the Affiliated Hospital of Chengde Medical University. According to the surgical method, the cases divided into minimally invasive group (fogarty balloon catheter thrombectomy under DSA guidance, 12 cases) and open group (incision and exploratory surgery, 23 cases). A comparative study of various indicators before, during and after the operation. Results There was no statistically significant difference in general information between the two groups at admission (P>0.05), and they were comparable; the time to vascular repatency, intraoperative operation time, and intraoperative blood loss in the minimally invasive group were significantly lower than those in the open group (P<0.05); the postoperative re-embolization rate and postoperative amputation rate of the minimally invasive group were significantly lower than those of the open group (P<0.05); there was no significant difference between the two groups in the rate of good limb function at 9 months postoperative follow-up (P>0.05); the hospitalization medical expenses open group was significantly lower than the minimally invasive group (P>0.05). Conclusion DSA-guided Fogarty balloon catheter removal for arterial crisis combined with thrombosis can avoid secondary damage to the repair area of the broken end, with low incidence of complications and definite early curative effect, but will increase medical costs.