Following femoral dorsalis pedis in situ bypass for toe gangrene, duplex surveillance of the bypass revealed proximal graft stenosis. Arteriography confirmed a large retained arteriovenous fistula. The patient underwent coil embolization with the aid of a microcatheter. Graft stenosis was approximately 30%. Gangrene of the toe healed, and the patient will have surveillance of the graft with duplex imaging every 6 months, with the possibility of angioplasty for graft stenosis in the future.