Three cases of late femoro-popliteal bypass graft failure have been reviewed. Each case presented with symptoms of limb-threatening ischemia and had an kle-arm indices of 0.12-0.30. In each instance, aortography revealed inflow oc clusion proximal to the graft, a well-developed collateral circulation, and patent grafts . Each of these cases was managed by extra-anatomic bypass . Etiologies of early, intermediate, and late bypass failure are discussed. With the growing popularity of the "in situ" technique of femoro-popliteal bypass, this observa tion may be made more frequently. These cases emphasize the benefit of regular followup, even in the long-term patency group. The durability of vein grafts is likewise noteworthy.
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