We report a case with segmental arterial calcification and atheromatosis of the superficial femoral artery in a patient with venous angiodysplasia (Klippel-Trenaunay syndrome). Pathogenesis remained unclear. A short hemodynamically significant stenosis within the calcified segment was treated by angioplasty requiring high balloon pressure and was complicated by an arterio-venous fistula. This fistula could successfully be closed by a dacron-covered endovascular prosthesis (Cragg-stent). There is little experience with covered stents to close arterio-venous shunts and our case may encourage further use in this indication.