Dear Editor,A 73-year-old white male has been adimitted with pain in his feet. Peripheral angiogram revealed 70% lesion in the ostium of the left anterior tibial artery which was the only vessel supplying the foot (Figure 1). A Pro-water wire was advanced up the distal anterior tibial artery. A 6 x 45 cm Raabe sheath was advanced over the wire. In order to minimize plaque shifting to pereneal artery, a 3.5 x 10 mm cutting balloon was advanced over the wire and inflated. Post inflation there was no significant residual stenosis (Figure 2). Key words: Peripreral artery disease, cutting balloon