Chronic total occlusions (CTOs) occur when the coronary artery is completely obstructed for more than three months. CTOs are very common, affecting between 15 and 50 percent of patients undergoing coronary angiography. Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) is increasingly being performed in patients with advanced coronary artery disease. This type of intervention requires skilled physicians who have expertise in opening CTOs. The Minneapolis Heart Institute® at Abbott Northwestern Hospital has established its CTO and complex PCI Center to best serve this population of patients. Manos Brilakis, MD leads this center to provide world class care and drive continued research to further improve outcomes for patients.