Objective To explore the effectiveness and safety of drug-coated balloon(DCB)angioplasty for i-solated popliteal lesions in patients with chronic limb-threatening ischemia(CLTI).Methods A retrospective analysis was conducted among 110 CLTI patients treated at Department of Vascular Surgery,Affiliated Beijing Chaoyang Hospital of Capital Medical University from June 2019 to June 2021.The target lesions for DCB intervention were popliteal artery.The primary effectiveness outcomes were clinical improvement of Rutherford classification and wound,ischemia,foot in-fection(WIfI)classification,and clinically driven target lesion revascularization(TLR).The primary safety endpoints included all-cause mortality and amputation.Potential factors influencing amputation-free survival were analyzed by mult-ivariate analyses.Results The average age of the patients was(72.7±9.2)years.The mean lesion length was(127.6±56.8)mm.Chronic total occlusion and severe calcification occurred in 79.1%and 62.7%of patients,re-spectively.Patients with advanced limb threat accounted for 20.9%.The incidences of all-cause mortality,amputation-free survival,and clinically driven TLR during the 12-month follow-up were 11.8%,81.8%,and 12.7%,respectively.Rutherford grade and WIfI(all P<0.001)stage were significantly improved after 3-month and 12-month follow-up.43.5%patients with advanced limb threat died or underwent major amputation during the 12-month follow-up.The Cox proportional hazards model revealed WIfI classification as independent predictors of amputation-free survival.Conclu-sions DCB angioplasty is safe and effective in isolated popliteal lesions patients with CLTI over the medium term.WIfI staging can be utilized for prognostic assessment in CLTI patients.