Choosing Wires and Techniques for CTO Crossing | Dr. Craig Walker at TED 2025

TED Congress info below. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━ PULSE CARDIOVASCULAR TED Congress is organized by the team at Pulse Cardiovascular Institute. The clinic was founded by Dr. Venkatesh G. Ramaiah, MD, FACS, and Dr. Anita Ramaiah, and they specialize in advanced endovascular care. Pulse Cardiovascular: https://pulsecardiovascular.com Venkatesh G. Ramaiah: https://www.pulsecardiovascular.com/a... ━━━━━━━━━━━━━━━━━━━━━━━━━━━━ ABOUT TED CONGRESS Transformative Endovascular Decisions (TED) is a national vascular and endovascular symposium held annually in Scottsdale, Arizona. The program brings together leading vascular surgeons, interventional cardiologists, and interventional radiologists for live cases, debates, and practice-based learning across peripheral, carotid, aortic, and venous disease. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━ LINKS Website: https://tedcongress.com LinkedIn:   / ted-congress   Vumedi: https://www.vumedi.com/channel/transf... Facebook:   / about   Instagram:   / tedcongress   ━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Join Dr. Craig Walker as he delivers a high-level technical session on *wire selection and crossing strategies for chronic total occlusions (CTOs)* at TED 2025, hosted by Dr. Venkatesh Ramaiah. In this expert-led presentation, Dr. Walker breaks down the decision-making process behind choosing the right guidewires and techniques when approaching complex peripheral CTOs. He emphasizes how lesion characteristics—such as calcification, cap morphology, vessel tortuosity, and distal reconstitution—directly influence wire strategy and crossing success. The session explores foundational and advanced CTO crossing techniques, including intraluminal “penetration and drilling,” subintimal navigation, and parallel wire strategies. These approaches rely on precise wire control, torque response, and tip load selection to safely traverse occluded segments while minimizing complications. Dr. Walker also highlights escalation strategies when initial crossing attempts fail, including transitioning to higher tip-load wires, utilizing re-entry devices, and adopting alternative access approaches such as retrograde or tibiopedal access. A key focus is adaptability—knowing when to persist with one strategy versus pivoting to another for optimal outcomes. Real-world case insights reinforce practical decision-making, procedural efficiency, and safety in complex limb salvage scenarios. This session is essential for vascular surgeons, interventional cardiologists, and endovascular specialists seeking to refine their CTO crossing skills and improve outcomes in patients with advanced peripheral arterial disease. Learn more about TED Congress Chairman Dr. Venkatesh Ramaiah: [https://en.wikipedia.org/wiki/Venkate...](https://en.wikipedia.org/wiki/Venkate...) Learn more about Dr. Craig Walker: [https://www.cardio.com/team/craig-wal...](https://www.cardio.com/team/craig-wal...) ([Cardiovascular Institute of the South][1]) --- *Timestamps:* 00:00 – Introduction 00:45 – Disclosures 01:05 – CTO Overview & Lesion Assessment 01:50 – Guidewire Selection: Tip Load, Support & Torque 02:40 – Intraluminal Crossing: Penetration & Drilling Techniques 03:30 – Subintimal Strategies & When to Use Them 04:20 – Parallel Wire Technique & Wire Escalation 05:15 – Re-entry Techniques & Devices 06:10 – Retrograde & Tibiopedal Access Approaches 07:00 – Troubleshooting Complex CTOs 08:00 – Case-Based Insights & Key Takeaways --- *Keywords/Tags:* CTO Crossing, Chronic Total Occlusion, Guidewire Selection, Peripheral Artery Disease, Dr. Craig Walker, TED Congress, Dr. Venkatesh Ramaiah, Endovascular Therapy, Vascular Surgery, Interventional Cardiology, Wire Techniques, Subintimal Crossing, Intraluminal Technique, Re-entry Devices, Tibiopedal Access, Retrograde Approach, Limb Salvage, Complex PAD, Catheter-Based Intervention, Clinical Education, TED 2025