42-year-old male with history of hypertension, type 2 diabetes and hyperlipidemia presenting with lifestyle-limiting lower extremity claudication with minimal exertion, after walking 2 blocks and resolves with rest (Rutherford grade I, category 3). Non-invasive studies suggestive aorto-iliac bifurcation disease with monophasic waveforms below the segment. Patient underwent CT Angio with bilateral iliac occlusion at the ostium and distal CIA reconstitution for planned endovascular intervention.