Crossing a CTO with a guidewire demands surgical skill and patience. With the intention to make CTO crossings easier, faster and less reliant on a physician’s skill, a number of specialized devices have been developed to treat the condition. The procedure is risky, as arterial puncture can occur if the device is pushed out of the lumen, leading to potentially disastrous consequences. As a result, CTO devices have a higher penetration rate in peripheral vascular procedures than coronary ones.