This report presents a safe, simple method of bypassing the abdominal aorta in a patient in whom the infrare nal portion of the aorta is unusable for proximal grafting and in whom axillo femoral bypass grafting is contraindi cated. In our patient the standard aor tofemoral bypass was considered un wise because of previous abdominal surgery and an occluded infrarenal aorta. A left axillofemoral with femo rofemoral was ruled out in view of his left hemiparesis and probable need for subsequent left nephrectomy. A right axillofemoral grafting was not possible because of right subclavian artery ste nosis.
