An 80-year-old woman presented with ischemic necrosis of the right medial heel area. She had a history of a prior crossover femoral–femoral graft. Patient underwent below-knee right femoral–popliteal non-reversed translocated great saphenous vein (GSV) graft. Intraoperatively, she had coagulopathy of unknown cause with diffuse bleeding at the operative site, resulting in a hematoma in the upper thigh. The patient had spontaneous drainage of the hematoma in the postoperative period. The graft became exposed, but healing occurred with wound care and antibiotics. A satisfactory revascularization of the gangrene lesion in the medial heel area was achieved after a stormy perioperative course.