Inclusion Criteria:  Presence of at least one DFU (grade 0 or 1 by University of Texas classification).8,9 Diagnosis of diabetes mellitus. Diagnosis of PAD. Ankle-brachial index (ABI) of < 0.9 in the same limb as the DFU. Aged ≥ 22 years.  Exclusion Criteria:  Rutherford 6 stage PAD Active DFU infection End-stage renal disease on dialysis HbA1c > 13%. Planned PAD revascularization. Prior stenting in posterior tibial artery. Re-vascularization procedure within 25 days prior to enrollment in the study. (Note: Patients who had re-vascularization procedure earlier than 25 days prior to enrollment are eligible for enrollment if they meet all other criteria). History or diagnosis of severe chronic venous insufficiency or mixed arterio-venous disease. Acute limb ischemia within 30 days prior to treatment. History or diagnosis of deep venous thrombosis below the knee in treatment leg. Any conditions that, in the opinion of the investigator, may render the patient unable to complete the study or lead to difficulties for patient compliance with study requirements, or could confound study data. Patient's enrollment in another investigational study that has not completed the required primary endpoint follow-up period (Note: Patients involved in a long-term surveillance phase of another study are eligible for enrollment in this study).  NOTE: Eligibility for patients with bi-lateral PAD will be assessed based on the leg that has more advanced PAD and DFU. For bi-lateral PAD patients only one leg with the more disease will be treated.