A challenging case of occlusion of the right femoral and right common iliac arteries: diagnostic intervention does not always innocent

A 44-year-old man presented to our hospital with intermittent claudication at a distance of 200–250 m. He had undergone percutaneous coronary intervention for unstable angina through the right femoral artery access 5 months ago. Physical examination was remarkable for a reduced right femoral pulse. Popliteal and pedal pulses were normal. On the basis of these findings, a diagnostic peripheral arteriography was planned. After the femoral sheath was placed, a control arteriography was performed to visualize the access site (Video 1). Because several attempts to advance a 0.035-inch guidewire failed, a 0.018-inch floopy guidewire was advanced to guide the cathe- ter insertion. The angiogram showed severe occlusion of the right common femoral artery (CFA) involving the right common iliac artery (CIA) (Fig. 1, Video 2)