Chronic total occlusion (CTO) percutaneous coronary intervention treatment algorithms have standardized the crossing strategy sequence to improve efficiency of CTO interventions based on angiographic criteria. Antegrade wire escalation (AWE) remains the most common CTO crossing strategy. Techniques presented in this article can improve the clinical utility of AWE crossing strategy for both novice operators as well as those experienced with the advanced crossing strategies. For the less experienced operator, these techniques may provide a framework to treat more patients safely and effectively.
