Chronic Total Occlusion Intervention
(opening totally blocked arteries)
What is it?
Chronic Total Occlusion (CTO) is complete or almost complete blockage of a coronary artery for more than 6 months; some may be for years. One of the most common reason for referral for bypass surgery is presence of one or more CTO’s. CTO Intervention refers to a procedure aimed at identifying and re-opening the blocked artery.
CTO is a long complex blockage composed of calcium and other fibrous materials obstructing a coronary artery causing conditions that include myocardial ischemia, angina, and poor left ventricular function. CTO is a challenging type of blockage requiring the skill of an experienced Cardiologist specializing in interventional procedures.
Most patients with a CTO have historically been the most challenging types of blockages to treat with an interventional procedure, and have traditionally required coronary artery bypass graft (CABG) surgery to treat the blockage. For those patients who have already undergone coronary bypass surgery, symptomatic CTO should be considered for percutaneous treatment (stent procedure).
The emergence of new technology and new percutaneous techniques have enabled experienced Interventional Cardiologists to offer patients this minimally-invasive option known as percutaneous coronary intervention for CTO (CTO-PCI), making it a viable treatment option for patients who are experiencing symptoms related to these blockages.
Chronic Total Occlusion (CTO) is complete or almost complete blockage of a coronary artery for more than 6 months; some may be for years. One of the most common reason for referral for bypass surgery is presence of one or more CTO’s. CTO Intervention refers to a procedure aimed at identifying and re-opening the blocked artery.
CTO is a long complex blockage composed of calcium and other fibrous materials obstructing a coronary artery causing conditions that include myocardial ischemia, angina, and poor left ventricular function. CTO is a challenging type of blockage requiring the skill of an experienced Cardiologist specializing in interventional procedures.
Most patients with a CTO have historically been the most challenging types of blockages to treat with an interventional procedure, and have traditionally required coronary artery bypass graft (CABG) surgery to treat the blockage. For those patients who have already undergone coronary bypass surgery, symptomatic CTO should be considered for percutaneous treatment (stent procedure).
The emergence of new technology and new percutaneous techniques have enabled experienced Interventional Cardiologists to offer patients this minimally-invasive option known as percutaneous coronary intervention for CTO (CTO-PCI), making it a viable treatment option for patients who are experiencing symptoms related to these blockages.
Why it’s done
When one or more coronary arteries becomes completely blocked a heart attack may occur which damages the heart muscle. If the blockage occurs more slowly, remaining coronary arteries may create a network of small blood vessels that allow the other coronary arteries to reroute the blood flow to the blocked area (auto bypass). This might not be adequate to meet the myocardial oxygen and nutrient demand and angina may occur. What to expect Chronic Total Occlusion Intervention are normally longer procedures compared with standard coronary intervention. The procedure is performed in a specialised cardiac catheterization laboratory. This is still considered as a minimally invasive (keyhole) procedure and performed via small incision in the groin or wrist. You will receive conscious sedation for the procedure. Your Cardiologist will discuss with you the nature and complexity of the procedure and success rate prior to embarking. This procedure may require rotational atherectomy and other dedicated highly specialised devices. |
The successful procedure will be completed with stent implantation and re-opening the blockage with restoring adequate blood flow to the heart muscle.
Cardiac interventionalists are now using special guide wires and catheters that are gently steered across the total blockages. The fine movement of the guide wire tip is much easier to control than previous guide wire tips, making the procedure far more effective. Each patient will be evaluated to see what treatment options is best based on the type and location of a total occlusion, patient’s age and co-existing medical conditions. By offering minimally invasive techniques and leading-edge technology, skilled Interventional Cardiologists are now able to provide minimally invasive treatment for Chronic Total Occlusions. |