62-year-old male, heavy smoker, with a long history of leg pain with walking. Lumar spine fusion was done with no improvement in symptoms. Exercise ABI's demonstrated severe peripheral arterial disease. CT angiography showed occlusion of the infrarenal abdominal aorta, bilateral common iliac arteries, left external iliac artery, and severe right external iliac artery disease. Recanalization was challenging and ultimately accomplished using a sharp reentry technique with a Chiba needle into the abdominal aorta. Covered endografts were used to treat the patient. ABI's were normalized post-procedure.