This 48 year old woman presented to the department of vascular surgery due to recurrent pain in both legs. She suffers from hypertension, hyperlipidemia and coronary artery disease. She has previously been diagnosed with a high-grade stenosis of the right internal carotid artery and occlusion of the left internal carotid artery, andis as well status post dilatation and stenting of the circumflex coronary artery. Additional relevant vascular disease and surgery include occlusion of the right subclavian artery, aortobifemoral bypass grafting due to high-grade stenosis, and occlusion of the common, external and internal iliac arteries on both sides. [...]