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and 15 to failure of the aorto-iliac reconstruction. Five patients had a second reconstruction and became symptom-free or improved. Four patients were symptomatically improved in spite of a failed operation. The total number of patients symptom-free or improved was 75 (80 per cent of 93 survivors).Femoropopliteal disease was present in 71 cases and, although in 12 patients the operation failed as a result of its presence, we do not advocate, as a routine, reconstruction of the femoropopliteal segment at the same time as the aorto-iliac operation.The choice of operation lies between thromboendarterectomy and by-pass grafting. The results of the different procedures are analysed and discussed. Thrombo-endarterectomy of the aorta and common iliac arteries gave a patency rate of 91 per cent and, we recommend its use for disease confined to the aorta and common iliac arteries. The aortofemoral by-pass graft gave a patency rate of 92 per cent and we advocate its use where the disease extends into the external iliac arteries.The management of the patient before, during, and after operation is discussed.

A case is presented of neurofibromatosis of the large bowel associated with a primary adenocarcinoma of the colon. This is believed to be the first report of such an association.

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