Following a failed iliac artery stenting, a 48-year-old man underwent aortobifemoral grafting. Subsequently, the patient had multiple revisions of the left limb of the graft. He developed anastomotic disruption of the left femoral anastomosis of the left femoral–popliteal graft with secondary hemorrhage. A left axillo-popliteal graft was performed with patency maintained for 9 months. He subsequently underwent a crossover right femoral-to-left popliteal PTFE graft, which remained patent for 30 months. However, the PTFE graft became exposed in the left groin, and tissue coverage was obtained with a gracilis muscle flap with satisfactory healing. He subsequently developed thrombosis of the crossover right femoral to left popliteal artery bypass, resulting in left above-knee amputation in March 2020. The patient was seen in the ER with acute ischemia of the right lower extremity in June 2023 due to thrombosis of the right femoral anastomotic aneurysm and thrombosis of the right femoral–popliteal bypass. Despite multiple attempts for limb salvage, the patient eventually had a right above-knee amputation and died in June 2023.