Does the present study put the whammy on the first-generation DES in CTO? This may be too early to conclude for several reasons. First, although this is the largest series of angiographic follow-ups after CTO-PCI to date, the data are derived from a single-center nonrandomized registry. Among CTO patients comorbidities and lesion morphologies are very variable and for the complex procedures different techniques are applied. These confounding factors cannot be excluded other than by performing an additional, randomized trial. Second, the EES findings cannot necessarily be applied to other second-generation DES. Third, the differences were only seen in the reocclusion rate and not in the binary restenosis rate. Unfortunately, the investigators did not provide us with the data necessary to comprehend the reasons for reocclusion. Was this a result of diffuse intima proliferation or rather a late thrombotic event? In many patients with reocclusion of a CTO, these events are not accompanied by symptoms. If thrombosis is the main mechanism, antiplatelet agents more potent than clopidogrel could potentially diminish the differences seen in the reocclusion rate between both groups of stents ((18),19), which might still keep first-generation DES on the shelf.