Pilot Study to Examine the Use of Rivaroxaban After Angioplasty for Critical Limb Ischemia

Inclusion Criteria: 1. Written informed consent. 2. Infra-inguinal PAD presenting as CLI defined as a Rutherford category of 3, 4, or 5 3. More than 50% stenosis in the target infrainguinal vessel 4. Good candidates for PTA using POBA (plain old balloon angioplasty) with or without stenting defined as TASC a and b lesions. Exclusion Criteria: 1. Rutherford scale of 0,1,2 or 6 2. Acute limb-threatening ischemia (e.g. embolic disease) 3. Previous infrainguinal bypass or PTA procedures of the affected leg 4. Hybrid procedures 5. Creatinine clearance \<30 mL/min 6. Platelet count \<100x109/L 7. INR \>1.5; Hbg \<100 g/L 8. History of or condition associated with increased bleeding risk including, but not limited to: 1. Major surgical procedure or trauma within 30 days before the randomization visit 2. Clinically significant gastrointestinal bleeding within 6 months before the randomization visit 3. History of intracranial, intraocular, spinal, or atraumatic intra-articular bleeding 4. Chronic hemorrhagic disorder 5. Known intracranial neoplasm, arteriovenous malformation, or aneurysm 6. Sustained uncontrolled hypertension: systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥100 mmHg 9. Severe, disabling stroke (modified Rankin score of 4 to 5, inclusive) within 3 months or any stroke within 14 days before the randomization visit 10. Aspirin in combination with thienopyridines within 5 days before randomization 11. Intravenous antiplatelets within 5 days before randomization 12. Fibrinolytics within 10 days before randomization 13. Known HIV infection at time of screening 14. Known significant liver disease (e.g., acute clinical hepatitis, chronic active hepatitis, cirrhosis or ALT \>3ULN) 15. Childbearing potential without proper contraceptive measures, pregnancy or breast feeding 16. Drug addiction or alcohol abuse within 12 months before the randomization visit 17. Systemic treatment with strong CYP 3A4 and P-glycoprotein inhibitors : such as ketoconazole, itraconazole, posaconazole, or ritonavir 18. Known allergy or hypersensitivity to any component of rivaroxaban, ASA or clopidogrel 19. Need for long term anticoagulation or double antiplatelet agents other than PAD such as atrial fibrillation, heart valve replacement, acute coronary syndrome, stroke or venous thromboembolism 20. Anticipated need for chronic (\> 4 weeks) therapy with non-steroidal anti-inflammatory drugs. 21. Concomitant treatment with any other anticoagulant, including oral anticoagulants, such as warfarin, dabigatran, apixaban, except under circumstances of switching therapy to or from study treatment. 22. Inability to adhere to protocol. 23. Severe concomitant condition or disease (e.g. life expectancy \<6 months secondary to cancer, advanced liver disease or dementia)