Explore the controversial aspects of chronic total occlusion percutaneous coronary intervention (CTO PCI) in this 55-minute grand rounds lecture from the Cardiology University of Washington. Gain insights into the pathophysiological foundations of CTO PCI and critically evaluate the indications for this procedure. Analyze the advantages, disadvantages, benefits, and limitations of various treatment approaches, including medical therapy, PCI, and coronary artery bypass grafting (CABG) for CTO. By the end of this comprehensive presentation, develop a deeper understanding of the complex decision-making process involved in managing patients with chronic total occlusions.