PREVENT: Promus BTK

General Inclusion Criteria: * Patient presenting with rest pain or minor tissue loss (Rutherford class 4 or 5) * Patient is willing to comply with specified follow-up evaluations at the specified times * Patient is \>18 years old * Patient understands the nature of the procedure and provides written informed consent, prior to enrolment in the study * Patient has a projected life-expectancy of at least 12 months * The treating physician consider the patient eligible for below-the-knee treatment with the PROMUS ELEMENT Stent (Boston Scientific) and PROMUS ELEMENT PLUS Stent (Boston Scientific) * Male, infertile female, or female of child bearing potential practicing an acceptable method of birth control with a negative pregnancy test within 7 days prior to study procedure Angiographic Inclusion Criteria: * Single or multiple lesions with minimally 70% stenosis in one or more infrapopliteal arteries, including the tibiofibular trunk * A maximum of two focal target lesions in one or more infrapopliteal vessels * Length of lesion is maximally 40 mm, allowing maximally 2 planned stents to be implanted * Target vessel diameter visually estimated to be \>2.5mm and \<4.0mm * Guidewire and delivery system successfully traversed lesion General Exclusion Criteria: * Patient refusing treatment * Previously implanted stent in the artery to be treated * Failed PTA of target lesion/vessel less than 3 months prior to study procedure * The reference segment diameter is not suitable for the available stent design * Untreated flow-limiting inflow lesions * Perioperative unsuccessful ipsilateral percutaneous vascular procedure to treat inflow disease just prior to enrollment * Any previous surgery in the target vessel (including prior ipsilateral crural bypass) * Aneurysm in the target vessel * Patient presents with renal failure, evidenced by a serum creatinine level \>2.0mg/dL * Patient presents with platelet levels above or below normal range * Non-atherosclerothic disease resulting in occlusion (e.g. embolism, Buerger's disease, vasculitis) * Severe medical comorbidities (untreated CAD/CHF, severe COPD, metastatic malignancy, dementia, etc) or other medical condition that would preclude compliance with the study protocol or 1-year life expectancy * Major distal amputation (above the transmetatarsal) in the study limb or non-study limb * Septicemia or bacteremia * Any previously known coagulation disorder, including hypercoagulability * Contraindication to anticoagulation or antiplatelet therapy * Known allergies to stent or stent components * Known allergy to contrast media that cannot be adequately pre-medicated prior to the study procedure * Patient with known hypersensitivity to heparin, including those patients who have had a previous incidence of heparin-induced thrombocytopenia (HIT) type II * Currently participating in another clinical research trial * Angiographic evidence of intra-arterial thrombus or atheroembolism from inflow treatment * Target lesion access not performed by transfemoral approach.