A patient with type I aortic dissection, ascending aortic aneurysm, and infrarenal aortic occlusion was managed by inserting an infrarenal bifurcation graft and using one limb as arterial access for cardiopulmonary bypass. Following ascending aorta and aortic arch repair, the aorto-bi-common femoral artery bypass was completed. In patients with severe aortoiliac occlusive disease, graft replacement can provide access for both cardiopulmonary bypass and intraaortic balloon pump insertion.