A multimorbid patient with chronic wounds on the left foot (Fontaine stage IV) was treated for a complete occlusion of the left external iliac and common femoral artery using endovascular techniques. A percutaneous crossover approach with the BYCROSS rotational atherectomy device and drug-coated balloon angioplasty successfully restored blood flow without the need for stent placement or complications. This minimally invasive method highlights that modern endovascular options, particularly the BYCROSS device, offer a valuable alternative to open surgery for complex cases, especially in multimorbid patients.

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