¹İstanbul Üniversitesi İstanbul Tıp Fakültesi Genel Cerrahi Anabilim Dalı, Damar Cerrahisi Ünitesi, İstanbul 23 patients with clinical stage III and IV arterial occlusive disease have undergone distal bypass proced=. for limb salvage. Doppler mapping or peroperative angiography was performed in all cases whom we could not have de¬tailed information about crural arteries with aortoperipheric angiography. Insitu saphaneous vein with aortoperipheric angiopraphie. Insitu sapheneous vein bypass technic was performed in all possible cases. Preoperative mean ABI as 0.26±0.12 (0-0.42). Postoperative mean value for ABI found 0.79±0.11 (0.46-1.20). 6 patients has undergone amputa¬tion because of occulusion of the bypass in the early period. We found 16 months patency rate as 60 % and limb salvage rate 80 % in ten patients whom we followed up. We found tibial and peroneal artery bypass procedures effective for limb salvage. Keywords :