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A 46-year-old female nurse with hypertension, a smoking history of 40 packyears and an extensive family history of peripheral vascular disease presented to her local physician with 8 weeks of right leg claudication and a poorly healing right foot laceration. Poor pedal pulses were noted on physical examination and verified with a resting right ankle brachial index (ABI) of 0.51. Abdominal aortography revealed mild aortic atherosclerotic changes with a total occlusion of the right common femoral artery (CFA), extending to the level of the profunda femoris and superficial femoral artery (SFA) bifurcation (Figure 47.1). Options for revascularization were discussed with the patient who elected for a percutaneous approach.