71-year-old female with a non healing ulcer on the left foot. Previously had a femoral to popliteal artery vein bypass graft which had occluded and was not salvageable. In addition, the patient had end stage renal disease but was not on dialysis. The long superficial femoral artery occlusion was crossed in the subintimal space. Reentry in to the popliteal artery required use of an outback catheter. Treatment with a convered endoprosthesis (Gore Viabhaun) was performed.