A method and systems for treating chronic total occlusions particularly those that are difficult to treat is disclosed. In this approach recanalizing the CTO is achieved using a combined antegrade and retrograde 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.
