A 58-year-old man who required long-term hemodialysis was referred to our institution for the management of life-limiting intermittent claudication of the right lower extremity. The diagnostic arteriography demonstrated heavily calcified chronic total occlusion in the right common iliac artery. The lesion was successfully treated with the combination of a Tornus microcatheter (Asahi Intecc, Aichi, Japan) and rotational atherectomy. We describe in this article a niche application of the Tornus microcatheter and the effect of the combination technique of it with rotational atherectomy in peripheral interventions.