How to cross the uncrossable lesions in chronic total occlusion

Coronary chronic total occlusion occurred in approximately 15 to 20% of patients. The most common challenges associated with successful percutaneous coronary intervention in chronic total occlusion are undilatable and uncrossable lesions. Uncrossable lesions are characterized as those lesions in which the balloon cannot cross the lesion. These types of lesions are commonly seen in calcified and tortuous arteries, and in chronic total occlusion. Various techniques, such as side branch anchoring, rotational, orbital, or laser atherectomy can be used to treat these challenging lesions. In this article, we describe the tips and tricks which can be commonly used to cross uncrossable lesions.