Chronic total coronary blockage is the number one reason patients are treated with bypass surgery instead of stents and the number one reason why complete revascularization cannot be performed using balloons or stents. New technologies and techniques have recently been developed to accomplish this goal, and they can make the difference between a patient undergoing open heart bypass surgery and less invasive treatment with stents. In this segment, Dr. Robert Riley, interventional cardiologist, discusses chronic total occlusion and when to refer to a specialist.