Balloon angioplasty was attempted, using hydrophillic Terumo guidewires, in 52 totally and subtotally occluded coronary arteries (50 patients), in which recanalisation by conventional angioplasty guidewires had failed. Hydrophillic guidewires had a crossing success rate of 65.4% (34/52); there was subsequently a technical success rate of 56% (29/52) and clinical success of 39% (20/52). Dissection of the coronary artery was seen in 16/29 technically successful cases. In 12/16 arteries, dissection was small and localised, whereas in 4/16 large and extended distally. There was one myocardial infarction and no peri-procedural deaths. Eleven out of 29 technically successful cases continued to be regarded as successful 12 mo postangioplasty. We conclude that the hydrophillic Terumo guidewire can improve the success rate in angioplasty of totally and subtotally occluded coronary arteries when conventional wires have failed.