Patients from different surgical specialities have a unique profile of predicted morbidity

many cases the only alternative is amputation. We ask whether the benefits justify the risks. Using a prospectively compiled database we identified patients undergoing simultaneous aortoiliac and infrainguinal bypasses between January 1996 and January 2011 at a single district general hospital. There were 38 multi-level procedures performed on 32 patients. Indication for surgery was acute ischaemia in 10 (26.3%), critical ischaemia without tissue loss in 10 (26.3%), with tissue loss in 10 (26.3%), and claudication in 2 (5.3%). In 26 (68.4%) cases inflow was restored using a direct aortoiliac or aortofemoral reconstruction. In the remaining 12 (31.6%) an extra-anatomic bypass was constructed. 1 (2.6%) patient died within 30 days of surgery. 36 (94.7%) patients survived to discharge. 34 patients (89.5%) were alive 1 year after surgery. Limb salvage was 97.3% at 30 days, 85.3% at 1 year and 76.7% at 5 years. In total 12 (35.3%) patients required at total of 21 further ipsilateral vascular procedures. Our results demonstrate good long term results with acceptable levels of post-operative mortality.