Access route for coronary chronic total occlusion: femoral or radial approach?

Percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTO) has historically been limited by technical success rates of 50–70%, despite being performed in highly selected cases. Currently, however, operators and programs with greater experience of CTO interventions and modern techniques and technologies can consistently achieve technical success rates of >80% in a more unselected and complex population of CTO patients. The transfemoral approach (TFA) represents the most extensively used access route for CTO treatment. However, recently there has been growing interest in using the transradial approach (TRA) to perform PCI for CT