A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. hi this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde 5 approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion. By appropriately maneuvering each member and applying radiofrequency energy between the proximal and distal ends of the occlusion, a continuous channel is created.
