This interventional prospective study aims to assess the effectiveness of single vessel versus multiple vessel infrapopliteal angioplasty in patients with chronic threatening limb ischemia . The study compares limb salvage rates and clinical outcomes across two groups over a defined follow up period

Inclusion Criteria: 1. patients aged 40 years or older 2. patients with Rutherford category "4" and "5" 3. patients with angiographic evidence of infrapopliteal vessel occlusive disease -

Exclusion Criteria:

1. patients who refuse to participate in the study
2. patients with isolated proximal arterial disease (e.g SFA or popliteal ) without infrapopliteal involvement
3. patients who develop acute thrombosis , flow limiting dissection or perforation in the infrapopliteal arteries during intervention -

not applicable data will be used internally for academic purpose only

due to nature of the intervention procedures masking was not feasible the number of infrapopliteal arteries treated is clearly documented in procedural reports and imaging and therefore both participants and treating physicians were aware of the assigned intervention