“…Generally, 20% of claudicants have multisegment involvement including the below-knee vessels [24], and it is exceptionally rare to find isolated below-knee atherosclerotic disease in this group [7]. Because of the low occurrence of disease, lack of evidence and attendant risks, endovascular treatment of run-off vessels in claudicants is not recommended, although some would advocate or suggest treatment in severe claudication [4,7,8]. Although controversial, crural angioplasty may also be useful to maintain adequate run-off -and hence patency -following femoral popliteal angioplasty or stenting, or femoral distal surgical bypass [5,8,25].…”