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well good afternoon everyone during this very short session weamp;#39;ll be talking about how to cross as FAC TOS win a glimpse little information on access options wire selection and support Kathryn Chase so itamp;#39;s important to realize that approximately 10 to 20 percent of coronary lesions that we treat our CTOs however more than 50% of the lesions that we treat in the periphery their chronic occlusions so how do we cross them well letamp;#39;s start with the basics letamp;#39;s talk about access access comes in two varieties if you may integrate and retrograde antegrade can be epsilon or contralateral we use antegrade access preferably when you have a proximal cap that is not ambiguous we prefer using oh three five inch hydrophilic guide wires with catheter support to attempt to cross the chronic total occlusion retrograde comes in two varieties as well popliteal or pedal nowadays more often than before weamp;#39;re using pedal axis and we use threads for great acc