In today’s era of expanding Intervention cardiology with improved and user friendly hard ware and good long term outcomes largely as a result of improved drug eluting stents and antiplatelet medication, CTO remains one of the important areas of challenge where operator experience and technical expertise still plays an important role in the final success of the procedure. Also this is one area that still needs more learning for all of us with largest experience existing with the Japanese operators world over. In light of the same Indo Japanese CTO club was formulated with like minded people with a view to offer opportunity for greater learning in this field for all. The group had its birth in July 2012 at the 3rd CACTO summit and the 1st live CTO summit India under the aegis of IJCTO was held in Mumbai in June 2013. This year it was held at Kochi, Kerala in June 2016. Dr Shirish MS Hiremath was invited to give a lecture. He spoke on various treatment options available for re-stenosis of existing stents placed in the coronary vessels.