Chronic Total Occlusions

A chronic total occlusion (CTOs) refers to a complete (100%) blockage in a coronary artery (a blood vessel supplying the heart muscle), which has been present for 3 months or longer. CTOs can be treated using PCI and are generally more challenging to treat than other types of narrowings or blockages.  The procedural time may be longer than a routine PCI and may last up to 2 hours or more in some cases.  At the beginning a CTO PCI both wrists or both groins are anaesthetized and used to insert catheters to the heart. This is done in order to enable images of the right and left coronary arteries to be recorded at the same time. The blockage may be treated by trying to pass a small wire through the front of the blockage (antegrade approach) or via the back of the blockage (retrograde approach). All patients undergoing a CTO PCI will generally have to be admitted overnight for monitoring but can usually be discharged the next day.