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Acute iatrogenic arterial dissection is a known complication of endovascular techniques and can be treated with prolonged ballooning, stent placement, or balloon fenestration. Treatment of common femoral artery (CFA) dissection needs special attention because of the potential compromise of either the deep or superficial femoral artery origin and the enhanced mechanical stress to arteries in the groin. The authors report two cases with percutaneous balloon fenestration of flow-limiting localized iatrogenic dissection of the CFA with initial technical success in both cases and favorable short- to midterm outcomes.