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References CHAPTER 18: Chronic Total Coronary Occlusion Introduction Morphology of the occlusion Indication for treatment Basic rules of engagement Guide wire selection and handling Advanced antegrade recanalization techniques Antegrade dissection and reentry Retrograde approach Algortihmic approach for intervention of chronic total occlusions Balloon dilatation Stent placement Intravascular ultrasound in CTOs When to stop a procedure Complications References CHAPTER 19: Percutaneous Coronary Intervention of Arterial and Vein Grafts Introduction Scope of the problem Secondary revascularization after CABG surgery: PCI or repeat surgery? PCI for acute post‐operative graft failure PCI in degenerated saphenous vein grafts Conclusions References CHAPTER 20: Interventional Approach in Small Vessel, Diffuse, and Tortuous Coronary Artery Disease Introduction Small vessel disease Diffuse vessel disease Tortuous vessel disease References CHAPTER 21: In‐Stent Restenosis in the New Generation DES Era Definition Incidence Clinical presentation Pathophysiologic mechanisms Morphologic pattern of DES restenosis Predictors of DES restenosis Role of coronary imaging Approach to DES restenosis References CHAPTER 22: High Risk Percutaneous Coronary Intervention Introduction Defining high‐risk PCI Pathophysiological rationale for mechanical support in HR‐PCI An integrated approach to high‐risk PCI Conclusion References SECTION V: Special Techniques and Complications CHAPTER 23: Laser, Rotational, Orbital Coronary Atherectomy, and Coronary Intravascular Lithoplasty Background Rotational atherectomy Excimer laser coronary atherectomy Orbital atherectomy Coronary intravascular lithoplasty Conclusions References CHAPTER 24: Thrombus‐containing Lesions Introduction How to deal with thrombus‐containing lesions Conclusions References CHAPTER 25: Specialized Balloons in Percutaneous Coronary Intervention Introduction Cutting and scoring balloons Coronary bifurcation sidebranch access Clearway catheter for intracoronary drug delivery Flash Ostial dual balloon angioplasty catheter Drug‐eluting balloons Conclusions References CHAPTER 26: Coronary Artery Dissections, Perforations, and the No‐Reflow Phenomenon Introduction Coronary artery dissection Coronary artery perforation Classification Devices and materials for CAP The no‐reflow phenomenon Management of distal embolization. Intracoronary infusions Conclusions References CHAPTER 27: Vascular Access Site Complications Introduction Common