How to Recanalize In-Stent Chronic Total Occlusions

In-stent chronic total occlusions (IS CTOs) remain one of the most difficult and challenging subset of lesions in the field of CTO interventions. In a modern practice, this is not a rare situation and the prevalence has been reported between 5 and 25 % of all CTOs. Given that patients with CTOs caused by in-stent restenosis (ISR) are usually excluded from clinical trials, little published data exists to guide coronary intervention in this setting.