A 62-year-old man with diabetes and end-stage renal disease was referred to our clinic for the management of a nonhealing wound in his right big toe (Figure 1A). Blood oxygenation level-dependent magnetic resonance (BOLD MR) foot images were obtained in conjunction with T2-weighted imaging, time-of-flight magnetic resonance (MR) angiography, and phase-contrast blood velocity mapping using a 3-T MR scanner. These tests revealed absent flow in the anterior tibial artery (ATA) and loss of arterial flow pattern in all infrapopliteal arteries (Figure 1B). Digital subtraction angiography showed diffuse segmental occlusion of all 3 major arteries from the proximal level, with reconstituted flow observed at the distal segment of the ATA (Figure 1C). Successful endovascular revascularization was performed for the ATA with restoration of flow to the lateral tarsal and first dorsal metatarsal arteries (Figure 2C). The skin perfusion pressure value measured near the wound at the dorsal surface increased from 8 to 56 mmHg after the procedure. Compared with the preprocedural one, the postprocedural phase-contrast MR angiography revealed restoration of the arterial flow pattern of the ATA (Figure 2B) and the BOLD MR revealed improved oxygenation (increased T2* values) mainly in the soft tissues of proximal half of the big toe, lateral foot border, and at the intrinsic foot muscles (Figures 1D and 2D). However, the tissue oxygenation failed to improve at the distal half of the big toe (an area of tissue gangrene, Figure 2A). The distribution of individual T2* values assessed from the whole foot (Figure 3C) as well as from the forefoot (Figure 3D) shifted to the right (increasing T2* values) after the procedure.1) The patient underwent first-toe amputation at the basal level of the proximal phalanx, and the amputation stump healed well without any complication.