This video consists of a reversed saphenous vein bypass of a popliteal aneurysm and the correction of a tibial arteriovenous fistula that was found as an incidental finding at the arteriogram. This video features: the reversed venous technique showing a tourniquet so that vascular clamps are not needed; the inside of an aneurysm using the optiscope; the measurements of flow through the bypass graft; and, the checks and balances that are used to make certain that the clinical result is maximum.