80 year old gentleman presents with slowly healing R foot 2nd toe ulcer (Rutherford Grade III – Category V, Fontaine stage IV, Wifi 1, 2, 1). His past medical history includes uncontrolled hypertension, Paroxysmal atrial fibrillation, Coronary Artery Disease s/p PCI to LAD in 2012, PAD s/p RSFA stenting at outside hospital 2 years ago. His medications include Aspirin, Eliquis, Metoprolol, Zocor and Lisinopril. He underwent ABI that was 0.35 in right lower extremity and 0.8 in left lower extremity. US Duplex showed severe in-stent stenosis of RSFA with distal occlusions and occluded AT. He underwent diagnostic peripheral angiogram at outside hospital that showed occluded RSFA stents with stent fracture with one vessel runoff. Here for Angioplasty of RSFA ISR.