Objective. To review our preliminary experience and evaluate our early results of a combined intraoperative iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease. Methods. From July 1999 to April 2000

intraoperative iliac angioplasty and stenting combined with simultaneous femoro- popliteal bypass were performed on 12 lower extremities of 10 patients suffering from multilevel atherosclerotic occlusive disease. There were 8 men and 2 women

average 72 years. The indications for procedures included disabling claudication in 3 and rest pain in 7 patients. Results. Eleven iliac angioplasty and stent procedures combined with simultaneous 9 femoro- popliteal bypass and 3 femoro- femoral- popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stent placement was technically successful in all patients. One contralateral femoral- popliteal bypass was failure after femorofemoral- popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortali- ty. Mean follow- up was 5 months （range 1～ 10 months）. During the follow- up period

one femoro- infrapopliteal graft became occluded after 7 months and above- knee amputation was required. The cumulative primary patency rate of stented iliac arteries

femoro- femoral bypass grafts and femoro- popliteal bypass grafts were 100％ （11/11）

100％ （3/3） and 90.9％ （10/11） in the follow- up period

respectively. The amputation rate was 8.3％ （1/12）. Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively performed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon

using a portable C arm fluoroscopy in the operating room. Furthermore

iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow

or to reduce the extent of traditional surgical intervention

and also

any angioplasty and stenting- related complications can be immediately corrected as well.