The Hybrid Approach for Percutaneous Revascularization of Coronary Chronic Total Occlusions.

Percutaneous recanalization of coronary chronic total occlusions (CTOs) has been limited by inability to consistently achieve wire position in the distal true lumen across the CTO segment, preventing many patients from having percutaneous coronary intervention (PCI). Furthermore, low success rates, prolonged case times, and wide variability in approaches has resulted in lower adoption of CTO PCI as a routine procedure and has limited educational initiatives. The hybrid approach for CTO PCI is predicated on an algorithm that allows trained operators to react to angiograms and craft strategies in a similar manner, enabling technical success and efficiency.