Chronic Total Occlusion

Completely blocked arteries can create a life-threatening condition or worsen the quality of life.

As the heart’s arteries become narrowed over time due to atherosclerosis (the buildup of plaque) and coronary artery disease, they can become completely blocked. This may also happen suddenly, when plaque ruptures in an artery and forms a clot. In either case, blood flow to the affected heart muscle is stopped. This can create a life-threatening condition and increase your risk for several complications, including chest pain (angina) and heart attack. When this blockage lasts for three months or more, it’s referred to as a chronic total occlusion (CTO), which may worsen the quality of life.

Symptoms of chronic total occlusion

Sometimes there are no symptoms of completely blocked arteries. When there are, these can include:

  • Chest pain (angina)
  • Trouble breathing
  • Heart palpitations
  • Fatigue or lack of energy
  • Tiredness
  • Nausea
  • Pain in the upper body, including the neck and arm

Diagnosis and testing

You need a cardiac catheterization and coronary artery angiogram to know if you have a chronic total occlusion. As part of your diagnosis, your cardiologist also will ask you about any symptoms and conduct a complete physical exam as well as a medical and family history. Your physician also may order routine blood tests, such as a screening to check your cholesterol levels. In addition, we may refer you for advanced diagnostic testing at Henry Ford Cardiovascular Laboratories, where we offer a complete spectrum of testing.

Treatment for chronic total occlusion

Your physician may recommend one or more medications, such as aspirin, beta blockers, calcium channel blockers or statins. These help to reduce your risk of heart attack or address related conditions, such as angina. Your physician also may recommend a procedure for your completely blocked arteries:

  • Chronic total occlusion percutaneous coronary intervention (CTO PCI): This minimally invasive procedure uses catheters and tiny wires to drill through the blockages in completely blocked arteries. CTO PCI can significantly shorten hospital stays, recovery time and pain. It offers an option to those whose quality of life is impacted by their coronary artery disease. Henry Ford is Michigan’s most experienced hospital for CTO PCI and is one of few centers in the United States performing the procedure at a very high success rate.
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