We report the results of more than 1000 PTFE tibial bypass implantations during the last 20 years. An extra-anatomic lateral bypass to the peroneal or tibial artery prevents angulation problems. Using the Linton patch technique, early results improved to 85%. In the context of redo-operations long-term results are enhanced through the consistent use of PIDDA catheter. In 57% we achieved our purpose: limb salvage until the death of the patient or for 3-7 years (3.8 years in the middle) at the time of reexamination. Two examples of lateral tibial bypasses are given that have been functioning for 18 years.