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Abstract Background:The value of peroneal artery-only runoff (PAOR) revascularization in chronic limb threatening ischemia (CLTI) has been debatable.This study aims to study the efficiency and safety of balloon angioplasty of peroneal artery as single runoff in infrapopliteal disease Patients and methods:This is a prospective study involving patients , whom all presented with critical limb ischemia due to infrapopliteal disease in the period between 1/5/2018 to 30/4/2020. Results:The study included 40 patients, with age ranging from 45 to 75 years; 65% were male. On 12 month, primary patency and limb salvage was 60% and 62.5% respectively.Besides, overall mortality rate was 7.5%.The highly significant factor was pedal runoff (foot arteries refilling); as Limb salvage at 12 months in patients with good pedal runoff was 75% compared with 12% in patients with poor pedal runoff (P = 0.001). Limb salvage at 12 months in (Rutherford 4) patients was 83.3% compared with 75% and 35.7% in (Rutherford 5) and (Rutherford 6) patients respectively (P = 0.035).12 month LS in DM, vs non-DM was 53.3% vs 90%(P = 0.038). Conclusion:We concluded that the balloon angioplasty of peroneal artery as single runoff, with good collaterals to the foot arterial circuit, in infrapopliteal disease is simple, safe and effective procedure in treatment of critical limb ischemia |