Percutaneous transluminal angioplasty (PTA), is a nonsurgical method of treating atherosclerotic ischaemic peripheral vascular disease. This paper describes the technique of intra-operative open transluminal angioplasty (IOTA) as an adjuvant therapy during vascular surgery. The main advantage is the shorter duration of surgical procedures. The procedure is simple and preliminary results are favourable, particularly in elderly patients or in patients reduced physical state. The initial impression of its effectiveness together with the low incidence of complications offers a new dimension for the preservation of the leg, especially in stage III and IV, in unfavourable cases such as recurrent stenosis, insufficient run-in or run-off and acute distal infection of the leg.