This document describes techniques for recanalization of chronic total occlusions (CTOs) including reverse CART (retrograde approach through collateral channels). It discusses 1) previous standardized retrograde techniques using retrograde wiring and kissing wire techniques, 2) limitations of these techniques, 3) the concept of contemporary reverse CART using antegrade ballooning instead of retrograde wiring, and 4) a recent standardized technique using IVUS guidance for improved outcomes. The success rate for recanalization using these reverse CART techniques was reported as 96%.