Peripheral Bypass Trial for Completion Control

Who May Qualify: - Chronic Limb-Threatening Ischemia as defined by presence of Peripheral Artery Disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration\>2 weeks duration (ref Global Guidelines) - Atherosclerotic infra-popliteal PAD - Adequate distal anastomotic target (crural, tibial or popliteal below the knee with one single run-off) between knee and ankle distal to the stenotic/occluded segment. - Available autogenous vein conduit based on preoperative vein mapping. - Understand the nature of the procedure and willingness to comply with protocol. Attend follow-up appointments and provide written willing to sign a consent form. Who Should NOT Join This Trial: - Bypass with artificial conduit or cryopreserved allografts - Bypass for non-atherosclerotic lesions - Life-expectancy less than 2 years - Any psychological, developmental, physical or emotional disorder that the investigator believes would interfere with surgery or follow-up. - Any condition that the investigator believes should exclude participation. - Excessive risk for adverse events during open surgery as judged by the investigator. Always talk to your doctor about whether this trial is right for you.