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4% with significantly higher success rates in the hybrid cohort (81.2% vs. 68.2%; p less then 0.001). Combining both cohorts, overall success rate increased over the years (2012-2017 respectively 65.2%, 60.0%, 71.7%, 83.2%, 77.9% and 81.4%). Complication rate was higher in the hybrid cohort compared to the non-hybrid cohort (4.6% vs 0.4%, respectively; p = 0.026). CONCLUSION By introducing a systematic CTO program, including use of the hybrid approach, we observed higher success rates of PCI CTO, despite increased complexity of t