Which is the best approach for percutaneous coronary intervention of chronic total occlusions? The one you feel most confident with!

Key points Percutaneous coronary intervention of chronic total occlusion remains a challenging niche, where minimization of technical failure and complication rates must be dearly pursued. The minimalist hybrid approach is a novel recanalization strategy which provides an individualized technical framework minimizing simultaneous dual injection and large‐bore catheters unless clearly needed. This study reports an observational comparison between a standard revascularization strategy for chronic total occlusion and the minimalist hybrid approach, suggesting the latter may be associated with some benefits, including more parsimonious use of costly devices.