Abstract
Key Points Chronic total occlusion (CTO) procedures are a well‐established treatment strategy for selected patients with chronic coronary disease. Proximal cap ambiguity is one of the key aspects impacting procedural success and final results. In this issue of CCI, data from a large multicenter prospective registry confirmed that proximal cap ambiguity is related to worse procedural outcomes, more aggressive procedural techniques, and higher rates of procedural complications. Proximal cap ambiguity should be considered for patients' selection and procedural planning. Further analysis will be needed to test different imaging modalities for a clearer cap visualization.
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