Method and apparatus for guiding a device in a totally occluded or partly occluded tubular organ

An apparatus and method for detecting, tracking and registering a device (218) within a tubular organ (210) of a subject. The devices include guide wire (216) tip or therapeutic devices, and the detection and tracking uses fluoroscopic images taken prior to or during a catheterization operation. The devices are fused with images or projections of models depicting tile tubular organs. Tile method and apparatus are used for treating chronic total occlusion or near total occlusion situations, by navigating a driller along the tubular organ (210) proximally to the occlusion point, in areas which are-not viewable in an angiogram, and optionally enabling the penetration of the occlusion in a preferred area.