80 year-old woman presented with left foot non healing ulcer (lateral aspect) (Rutherford Grade III – Category V, Fontaine Stage IV, Wifi 1,2,1). Her medical history includes non-obstructive CAD, PAD s/p DCB PTA of LSFA and PTA of L AT in 2014, 2nd left toe amputation, hypertension, Insulin dependent Diabetes Mellitus, ESRD on HD, permanent atrial fibrillation, Pacemaker implantation, and Dyslipidemia. Her current medications include Aspirin, Plavix, Lopressor, Insulin, Crestor, sensipar and antibiotics. She underwent resting Ankle Brachial Index (ABI) which was 0.6 on right lower extremity and 0.3 on left lower extremity. US Duplex showed long segment occlusions of infra popliteal vessels. Now planned for Percutaneous Transluminal Angioplasty of LAT/LPT (based on US Duplex).