In 30 cases at our clinic, bovine internal mammary arterial grafts, were used for femoro-popliteal arterial bypass on patients to be re-operated due to obstruction. All patients had previously gone through coronary bypass in the period 20092011, and subsequently had no saphenous veins or whose saphenous vein quality and diameter was inadequate where a Dacron (R) synthetic graft, autologous saphenous vein or PTFE were used. Alongside of the peripheral arterial bypass, aortabffemoral bypass with a Dacron (R) graft was performed on six patients. After the operation, all patients were monitored at week 1, week 4 and week 8 by arterial colored Doppler ultrasoundography, and MR angiography was performed at week 12 and MR angiography was performed at year 1. Early period check-ups (postoperative, week 12) and medium term follow-ups (postoperative year 1), no obstruction was detected except in 4 patient. The No-React (R) treated Shelhigh internal mammary artery graft may be an alternative to saphenous vein and inorganic tubular grafts for femoro-popliteal arterial bypass operations in cases where autologous veins are not available. As evidenced by the patient cohort and early period results, this alternative may be particularly useful for patients which 1) are to be reoperated due to obstruction; 2) who had gone through coronary bypass and have no saphenous veins; or 3) whose saphenous vein quality and/or diameter are inadequate where Dacron (R) saphenous vein or PTFE were used.