 This prospective, randomized, multi-center, post-market study of approximately 50 subjects randomized 1:1 to Orbital Atherectomy OA performed with Cardiovascular Systems, Inc.s Orbital Atherectomy System OAS followed by adjunctive balloon angioplasty BA vs. BA alone for treatment of tibial vessel disease, defined as 50 stenosis of the anterior tibial AT, posterior tibial PT, tibial peroneal trunk TPT, or peroneal PR arteries by angiography. All subjects will have a corresponding wound being fed by the target vessel which will be assessed during the study. 