Going through or around the occlusion? All roads lead to rome

This meta-analysis approaches one of the most heavily debated aspects of the chronic total occlusion (CTO) technique. How soon should operators switch from the conventional wire escalation (WE) technique to the creation of a subintimal path. Peripheral interventionalists use the latter technique as standard in very long occlusions of the superficial femoral artery or infrapopliteal vessels but their reocclusion rate is high and stenting is used more rarely. Flow rather than lumen size appears to be the determinant of late patency in this setting.