A patient with prior CABG presented with medically refractory angina due to a RCA CTO. The SVG-RCA was occluded. The RCA CTO had an ambiguous proximal cap, long length and the distal vessel was filling via septal collaterals from the LAD and via an ipsilateral collateral from the proximal RCA. Given proximal cap ambiguity a primary retrograde approach was used. The patient developed ischemic changes that resolved after balloon angioplasty of the proximal LAD. A retrograde guidewire was advanced to the proximal RCA, followed by antegrade extraplaque wiring and successful reverse CART during the DRAFT technique (Deflate, Retract and Advance into the Fenestration Technique). Antegrade injection after predilatation showed CTOs in the right posterolateral and the mid PDA. We used a Sasuke microcatheter to advance a Pilot 200 wire extraplaque wire in the right posterolateral, followed by successful reentry with a Stingray balloon. The PDA CTO could not be recanalized. Antegrade flow to the right posterolateral and the proximal right PDA was restored after stenting.