Advanced wiring technique for chronic coronary total occlusions

Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is one of the greatest challenges in interventional cardiology. The procedural success rate is relatively low, mainly due to guidewire failure to cross the occlusion. An effective wiring technique is the key to the success of CTO-PCIs. However, success or failure of wire crossing is mostly dependent on an operator's experience and skill. To improve the success rate of CTO-PCI in current interventional cardiology, several techniques were introduced in the Japanese CTO club. In this article, some advanced wiring techniques developed by the Japanese CTO club will be explored.