The treatment of lower extremity atherosclerosis can be broadly divided into basic treatment and surgical treatment, and surgical treatment can be broadly divided into endoluminal treatment and open surgery, endoluminal treatment has the advantage of minimally invasive, while open surgery often has good long-term results. For complex and critical cases, vascular surgeons can often apply both endoluminal treatment and open surgery “hybrid surgery” to improve the treatment effect. A patient nearly 80 years old with severe resting pain in the right lower extremity for 1 month, CT angiography showed that the right iliac artery was almost completely occluded and the right common femoral artery was partially occluded involving the arterial bifurcation, in this case, the open surgery was very traumatic and the mortality rate was high, while the intracavitary treatment had defects such as cross-joint and damage to the lateral circulation of the limb. We used right iliac artery thrombus removal + stenting + right common femoral artery thrombus endothelial debridement, which not only did not expose the elderly to excessive surgical trauma, but also avoided the contraindications of endoluminal treatment, so that the patient improved the treatment results and the blood flow of the lower limbs improved significantly.