A venous graft of the internal iliac-artery is necessary when endarterectomy is impossible, has failed or is contra-indicated owing to the poor state of the profunda femoris artery. However we prefer a dacron prosthesis to a saphenous autograft. A venous graft may be used alone or in association with another plastic procedure, in particular aortic thrombo-endarterectomy of the common iliac artery. The saphenous vein may be used as a by pass on the external iliac artery. The authors report 90 personal cases which illustrate their concept.