Ischemic gangrene of the arteries of the lower extremities is usually combined with a more severe bacterial infection. This infection causes gangrene of the tissues and, because of the concomitant blood flow disorders, results in very difficult infection control and little possibility of gangrene healing, even with highly sensitive antibiotics. Also, this bacterial infection of the affected limb poses a great risk of infection for revascularization surgery, which may result in systemic dissemination of bacteria and more surgical complications after restoration of blood flow. Therefore, for the affected limb with lower limb arterial ischemia with severe ischemia, amputation should be considered for treatment. However, the latest technology of leg preservation by interposition of artificial vessel saphenous vein arterialization for severe ischemia of lower limb has overcome this problem.