Aim. To evaluate the effectiveness of open surgery in patients with critical lower limb ischemia after previous balloon angioplasty and stenting. Material and methods. 38 patients with critical lower limb ischemia after previous endovascular intervention were treated. Endovascular re-operation was not possible due to the level of arterial occlusion (over 10 cm) or localization of the lesion. Mean age was 68±4.8 years. There were 32 (84.2%) men and 6 (15.8%) women. All patients were divided into two groups: group I consisted of 20 patients with arterial lesion above inguinal ligament. Group II included 18 patients with lesion below inguinal ligament. Open reconstructive operations were performed in all patients: bifurcation aorto-femoral bypass, deep femoral artery repair, femoral-popliteal bypass. Results. Safety of lower limbs and grafts patency in both groups was 100% in 6 months after operation. 3-year patency was 100 and 96% in groups I and II respectively. There were no amputations. Conclusion. There were no significant differences in surgical results and augmentation of pain-free walking distance, transcutaneous oximetry in both groups. However, ankle-brachial index was significantly higher in group I.