Ars Longa, Vita Brevis

Ease of use has dictated the destiny of all new techniques and devices in interventional cardiology. The popularity of stents began when they became as easy to use and more predictable than balloons. Conversely, directional and rotational atherectomy fell into oblivion or became confined to a small niche application. Some of these devices have been underused, even when proved beneficial, such as filters in saphenous vein graft treatment or thrombectomy in acute myocardial infarction. For chronic total occlusions (CTOs), the only route to success passes through the use of multiple dedicated wires, guided by contralateral injection, and of over-the-wire (OTW) balloons or microcatheters, sometimes inserted retrogradely via collateral vessels with the use of devices with exotic names like Tornus and Corsair (Asahi Intecc, Nagoya, Japan).