Study Summary: This study is testing a new tool called the VasoStar Vibrational Guidewire System. A guidewire is a thin wire used by doctors to help open blocked blood vessels in the heart. The goal is to see if this new guidewire can better cross hard-to-treat blockages in heart arteries, which are called chronic total occlusions (CTOs). CTOs are 100% blocked arteries that have been this way for over three months. The study is for adults who have these blockages and have not been helped by usual guidewires.

• Participants must be willing to follow study rules and sign a consent form.
• Those who have already successfully used a traditional guidewire or have other serious health issues cannot join.
• The study focuses on non-twisted artery blockages and requires specific health conditions to be met.

Risks and Considerations: As this is an early study, the risks and benefits of the new guidewire system are still being evaluated. Participants should discuss with their doctor to understand potential risks and make an informed decision.