The title of this book defines the primary indications for peripheral reconstruction in the extremities: gangrene and severe ischemia. It represents material presented at a vascular surgical symposium held at Northwestern University Medical School, Chicago, in 1978. As such, it shows the advantages of having multiple authors, each an eloquent authority in the area to which he has been assigned. A variety of critically important aspects of ischemia is thus well presented. Three authors present their concepts of the pathophysiology of atherosclerosis without rehashing the controversial details of lipid metabolism. Evaluation of the patient by angiographic methods is matched by excellent presentations on noninvasive methods carried out before, during, and after operation. Lumbar sympathectomy is discussed dispassionately and fairly, but it is the only conservative therapeutic modality given much space. The results of a variety of surgical combinations and techniques are presented in detail, but if the reader were seeking