Coronary CTO PCI Using Antegrade Wiring Strategy With a First-choice Gladius Guidewire (Gladius First)

Inclusion Criteria: * delivery of an informed consent and compliance with study protocol * CTO of a major coronary artery with at least intermediate difficulty score (J-CTO ≥1) as assessed by invasive angiography * referral to clinically indicated CTO PCI with intended primary antegrade wiring strategy Exclusion Criteria: * in-stent CTO * unstable angina and/or myocardial infarction * prior myocardial infarction within 4 weeks before study enrolment * CTO of a major coronary artery with an easy difficulty score (J-CTO 0) as assessed by invasive coronary angiography * lack of valid antegrade wire escalation strategy as assessed by 2 independent CTO PCI operators * chronic kidney disease (defined as eGFR ≤30 ml/min/m2) * contraindication to antiplatelet therapy and/or heparin * severe inflammatory disease * positive pregnancy test or breast-feeding