Abstract： Objective To explore the short-term efficacy of conventional balloon and drug-coated balloon(DCB)in the treat-ment of stent restenosis in lower limb arteriosclerosis obliterans(ASO).Methods Ninety patients with lower limb arteriosclerosis oc-clusive stent restenosis admitted to our hospital from January 2021 to December 2022 were selected and divided into a common group(45 cases,non-compliant posterior balloon conventional balloon treatment)and a drug-coated group(45 cases,drug-coated balloon treatment)according to different treatment plans.The levels of vascular endothelial function[P-selectin,nitric oxide(NO),and endo-thelin-1(ET-1)]were observed before surgery,12 hours,and 7 days after surgery.The Rutherford grading,ankle brachial index(ABI),and targeted vascular patency between the two groups at preoperative,postoperative 6 months and 12 months,were compared,re-spectively.Results At 12 hours and 7 days after surgery,the levels of P-selectin and ET-1 in both groups were higher than before sur-gery,while the levels of NO were lower than those before surgery(P<0.05);The levels of P-selectin and ET-1 in the drug-coated group were lower than those in the control group(P<0.05),while the levels of NO were lower than those in the control group(P<0.05);The Rutherford grading was lower than that before surgery at 6 and 12 months postoperatively(P<0.05);The Rutherford grad-ing of the drug-coated group was lower than that of the control group,and the difference was statistically significant(P<0.05);The ABI values of the two groups were higher than those before surgery at 3 days,6 months,and 12 months after surgery(P<0.05);The ABI val-ues of the drug-coated group were higher than those of the control group at 6 and 12 months after surgery,and the difference was statis-tically significant(P<0.05);At 6 and 12 months after surgery,the targeted vascular patency rate in the drug-coated group was higher than that in the control group(P<0.05),and the CD-TLR in the drug-coated group was lower than that in the control group,with sta-tistical significance(P<0.05).Conclusion Drug-coated balloon therapy can reduce damage to endothelial function in patients,im-prove lower limb ischemia,and maintain targeted vascular patency.