PURPOSE: To evaluate the results of percutaneous transluminal angioplasty in the prevention of bypass graft failure with dilatation of the anastomotic and perianastomotic obstructions following surgery. MATERIALS AND METHODS: Fourteen proximal or distal anastomotic/perianastomotic obstructions in one illiofemoral, one aortofemoral and ten femoropopliteal bypass grafts in eleven patients were diagnosed by clinical examination, Doppler ultrasonography, intravenous and intraarterial DSA in a follow-up period of 4-24 months after surgery. Percutaneous transluminal angioplasty was attempted in these anastomotic or perianastomotic lesions including two occlusions. RESULTS: Percutaneous transluminal angioplasty was successful for all cases. In a follow-up period of 4-45 months, eight patients remained asymptomatic with patient grafts. In one patient, the graft was occluded in the fourth month. In two others, restenosis occurred at the seventh and seventeenth months and required redilatation. Cumulative primary patency rate for one year was 92 +/- 6.8%. CONCLUSION: Percutaneous transluminal angioplasty is an effective alternative treatment modality for anastomotic and perianastomotic bypass graft-related obstructions and may enhance the overall graft patency.