Revascularization of coronary arteries with chronic total occlusion (CTO) was thought to be one of the last frontiers in coronary intervention. Here, a 75-year-old female patient with percutaneous coronaryintervention (PCI) for left anterior descending artery (LAD) CTO lesions via radial approach is described, in which target-vessel revascularization was performed via guidance of IVUS with a 6F guiding catheter. This technique salvaged long-tract dissection which was induced by false lumen wiring followed by long-tract balloon dilatation. Successful re-wiring to the true lumen could be done via the guidance of IVUS, even by radial approach with only the 6F guiding catheter.