Cardiogenic shock remains the leading cause of mortality among patients admitted for acute myocardial infarction (AMI). Percutaneous left ventricular assist devices (pVAD) represent one possible means of supporting these critically ill patients during interventional procedures. Tandem Heart is one such pVAD, which uses transseptal cannulation and a paracorporal centrifugal pump to maintain active circulation to the descending aorta. Despite its overall effectiveness in clinical use, the use of the Tandem Heart has several potential limitations, including a contraindication for patients with peripheral artery disease. This case report describes the successful use of the Tandem Heart in one such patient requiring a high-risk coronary intervention procedure with otherwise prohibitive peripheral arterial disease, by employing peripheral artery angioplasty.