62-year-old female, a heavy smoker, noticed a relatively sudden worsening of chronic right calf claudication. Ultrasound and CT angiography demonstrated occlusion of the common femoral artery. The patient is overweight with a body mass index of 35. The patient was self-employed and did not want to, nor could afford the time off work to undergo a common femoral endarterectomy. Endovascular repair with pathway atherectomy in a 60-minute procedure. The patient spent a total of 4 hours at our outpatient center and was back at work the next day. At 6 months, the patient stopped smoking and remained symptom-free—optimal medical therapy with blood pressure control, statin, and dual antiplatelet therapy. Arterial ultrasound shows a widely patent CFA, and exercise ABI's are essentially normal.