Peripheral arterial circulatory disorders is an important cause of morbidity and mortality today. Extra-anatomic bypass operations in patients which have high risk for limb salvage are alternative methods that may be preferred. In this case, we aimed to present a 54 year-old male patient who underwent extraanatomic bypass graft surgery for chronic aortoiliac occlusive arterial disease under local and tumescent anesthesia because of to accompany with advanced stage chronic obstructive pulmonary disease and resting dyspnea, previous thoracic aortic surgery and migrated lumbar disc hernia operations.