88 year old female presents with non-healing Left big toe ulcer (dorsal aspect) with claudication at rest (Rutherford Class III – Category V). Her risk factors include hypertension, dyslipidemia, paroxysmal atrial flutter, ex-smoker and CKD (Cr 1.8). She currently takes Aspirin, Pletal, Metoprolol, Rosuvastatin and Furosemide. US Duplex showed severe stenosis of Left Superficial Femoral Artery (LSFA) and infrapopliteal vessel occlusions. She underwent LSFA Directional Athrectomy and Drug coated Balloon (DCB) Angioplasty on 08/10/2015. Now planned for Antegrade/Retrograde approach Percutaneous Transluminal Angioplasty of L AT.