A 48-year-old man was urgently hospitalized for massive bright red bleeding from a rupture of a varicose bundle in the lower third of the posterior aspect of the right thigh. He had, 5 years previously, a femoral to posterior tibial artery bypass with an in situ saphenous vein for critical ischemia. The clinical examination showed the presence of a varicose pack not systematized at the level of the lower third of the posterior face of the thigh, surmounted by an ulceration. The blood pressure was 80/50 mm Hg and a heart rate was 110 per minute. CT angiography of the lower limbs, revealed a venous bypass permeable, with multiple aneurysmal arteriovenous fistulas (Figure A). The patient was immediately operated (Figure B and C). He had an exclusion by section ligation of all the aneurysmal and non-aneurysmal arteriovenous fistulas. The ultrasound check-up at 6 months was satisfactory.