Repeat aorto-bifemoral graft was performed using a transperitoneal approach in a 65-year-old woman for an occluded aorto-bifemoral graft performed 15 years earlier. There was a major venous injury to the left common iliac vein during dissection for tunneling of the right limb of the Dacron graft into the groin. Bleeding was controlled by lateral venography. The graft had remained patent for 17 years until her death from dementia.