The document discusses techniques for treating chronic total occlusions, including reverse controlled antegrade and retrograde subintimal tracking (CART), antegrade and retrograde wiring approaches, and using intravascular ultrasound (IVUS) to determine the appropriate approach. It provides steps for making a connection when wires are in different lumens and case examples. The conclusion emphasizes using IVUS to understand what has occurred and what should be done during chronic total occlusion percutaneous coronary intervention.