68 yo male with a background of PAD, CKD, DM, HLD, HTN, CAD, MI, PCI, COPD/Asthma was admitted with right 5th toe gangrene and severe rest pain. Underwent successful intervention of the right popliteal artery CTO with residual severe infrapopliteal disease. Given his renal insufficiency, he did not undergo further endovascular intervention. His rest pain persistent and he underwent right 5th toe amputation. The patient continues to have forefoot pain and poor wound healing. His TcO2 is 40mmHg. Hence plan for infrapopliteal intervention.
