Acute and subacute ischemia of the legs in acute and subacute femoropopliteal stent occlusion are dramatic conditions which endanger the survival of the limbs depending on the severity of the ischemia. A 56-year-old male patient with generalized atherosclerosis, particularly extensive in lower limb arteries, was admitted to our clinic 10 months after endovascular procedure for critical ischemia of the left lower limb. Angiography revealed an occlusion of the superficial femoral artery along its entire length, including previously implanted stents. A decision was made to perform percutaneous mechanical thrombectomy using the Rotarex system with retrograde popliteal approach followed by a stent-in-stent placement procedure. Follow-up angiography and Doppler ultrasound scan at 24 hours after the procedure and at sixth months revealed a patent vessel with satisfactory blood flow. Percutaneous mechanical thrombectomy with retrograde popliteal approach is an invaluable option for the treatment of acute femoropopliteal stent occlusion in high-risk patients, in particular, for surgical treatment.