Coronary chronic total occlusions (CTO), in spite of excellent progress in the field of medicine, remain a great challenge for interventional cardiologists. CTO is defined as the occlusion of a coronary artery with a thrombolysis in myocardial infarction (TIMI) score of 0 flow estimated for >3 months duration. CTO is observed in 15–30% of diagnostic coronary angiograms.