79-year-old female with non healing ulcers. Occlusion of all three arteries in the calf. Antegrade attempt at opening the anterior tibial artery failed. Retrograde crossing from the distal anterior tibial artery was successful. Treated with orbital atherectomy and angiograplasty. Ulcers healed in under 4 weeks. Entire procedure done in 75 minutes. Patients entire stay was under 4 hours.