Project Summary/Abstract We propose to develop a novel angioplasty balloon inflation system to improve the efficacy of drug-coated balloon angioplasty. Atherosclerosis, characterized by the deposition of plaques of fatty material on the inner walls of arteries, can lead to the development of peripheral arterial disease (PAD) due to obstructive narrowing of arteries that supply blood to the extremities. PAD frequently causes a wide variety of ischemic symptoms including pain, non-healing arterial insufficiency ulcers, lower limb tissue loss and gangrene. Percutaneous drug-coated balloon angioplasty of PAD blockages has been observed to reduce symptoms, salvage affected limbs and prolong survival.