A 73-year-old male presented with angina and a history of hypertension, smoking, and prior coronary angiography showing three-vessel disease without intervention. Angiography revealed a chronic total occlusion of the proximal right coronary artery and ischemia in the inferior and inferolateral walls on PET imaging. The patient was being evaluated for retrograde recanalization of the chronic total occlusion in the right coronary artery.