A 76-year-old, diabetic, hypertensive woman with atherosclerotic cardiovascular disease presented with increasing claudication. She had undergone aortobifemoral bypass (PTFE graft) through a left flank retroperitoneal approach three years prior to presentation. All anastomoses were end to side. Reconstruction of her CT angiogram showed stenoses at the right femoral anastomosis and aneurysmal dilatation at the left.