Abstract
A 63-year-old man on hemodialysis with diabetic nephropathy had ischemic necrosis of both lower limbs (Rutherford 6 on right, 5 on left). Preoperative angiography revealed occlusive lesions of all peripheral arteries below trifurcation. Bilateral distal dual bypasses were performed and all wounds were completely healed. If the vascular network of foot is poor for the lesions of pedal arch and perforator, and the necrosis was wide or on two areas, dual bypass seems effective.
