Results from 9 complete reconstructions without intermediate anastomosis (8 patients) are presented. In five cases a by-pass from femoral artery to the contralateral popliteal (infra or supra-rotuliar) arterial prosthesis was performed. In other case a by-pass from the aorta artery to the third popliteal section was placed. Other by-pass was performed from the branches of an axillo-bifemoral by-pass to the third popliteal section. The last case was an axillo-bi-popliteal by-pass. All the patients presented a severe ischemia (III and IV Fontaine stadii). Eight millimeter PTFE grafts were used. The distal anastomosis should always be performed in vessels with a low distal resistance.