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What is a Coronary Chronic Total Occlusion?
Coronary arteries with severe blockages, up to 99%, can often be treated with traditional stenting procedure. Once an artery becomes 100% blocked, it is considered a coronary chronic total occlusion, or CTO. Specialized equipment, techniques and physician training are required to open the artery with a stent. CIS has a number of physicians with training and expertise to safely and effectively open coronary CTOs. Opening coronary CTOs have been shown to improve symptoms of coronary artery disease, improve heart muscle pump function, and improve quality of life in patients with this condition.
Blockages of the coronary arteries, including CTOs, are the result of coronary artery disease. In this condition, the lining of arteries is damaged and narrowed over time as fatty deposits collect and plaque develops. This process is known as atherosclerosis. If this process develops slowly enough, a vessel can become 100% blocked and the artery will fill by new small vessels called “collaterals.” This is the body’s way of naturally bypassing the artery to keep the heart muscle alive. Unfortunately, these new collateral vessels are often inadequate to provide additional blood flow needed for physical exertion. Patients with CTOs often feel chest pain, shortness of breath, and have poor exercise tolerance.
The risk factors associate with Chronic Total Occulsion are:
If a physician suspects that a total coronary artery blockage has occurred, they will order one or more of the following tests to confirm the diagnosis:
There are several possible treatments for CTO. Determining which is best will depend on the patient, their current health and medical history.
Many patients, either due to preference, comorbid conditions, weak heart muscle, or prior cardiac surgery are unable to get bypass surgery and their anatomy is too complex for traditional stenting. CIS has a comprehensive program available for patients to receive the best care possible with the most advanced technology without the need for open heart surgery. This often includes the use of two novel procedures (1) Protected Percutaneous Coronary Intervention (Protected-PCI) and (2) Coronary Chronic Total Occlusion Interventions (CTO-PCI).
Protected PCI is a newer, yet widely-used procedure using Impella®, the world’s smallest heart pump, to temporarily assist the pumping function of the heart. During a PCI procedure, the Impella® heart pump ensures blood flow is maintained to critical organs such as the brain, lungs, and kidneys. The heart is allowed to rest, as the pump takes over the job of efficiently moving the blood while the blockages in coronary arteries are being repaired.