The patient was a 55-year-old male, known to be a chronic heavy smoker, diabetic, and taking oral hypoglycemic drugs. He came to the emergency department complaining of numbness, coldness, and a severe rest pain in his left foot that started several days before coming. The pain increased in intensity 2 days before his visit. Clinical examination revealed a cold left foot and lower leg in comparison to the right. There were intact and equal femoral and popliteal pulsations in both sides and no distal pulsations in both sides could be felt. Also, impaired motor power and sensation was noticed in the left foot. Duplex arterial study revealed total thrombotic occlusion of distal 1/3 of anterior tibial, posterior tibial, and total