more comfortable for patients because it allows early mobilization and also saves more lives. Risk of bleeding and vascular complications is extremely low with radial access. Radial access should be preferred over femoral access, even for angioplasty in CTO. Angina can recur in post-bypass patients from ungrafted coronaries or failed grafts.

Chronically totally occluded arteries can be revascularized successfully transradially even in post-bypass patients, if they are culprits for angina. A CTO can be approached both antegradely and retrogradely. Antegrade attempt should be made first.

Appropriate guiding catheter and wire selection is important for success. CTO revascularization can be done using slender techniques with 5F guide catheters in patients with small diameter radials in small individuals including women. Slender techniques are important because a third of our patients are either women or small.