Chronic Total Occlusion (CTO): Symptoms, Risks & Treatments

What is chronic total occlusion (CTO)?

Chronic total occlusion, commonly referred to as simply CTO, is a complete blockage of a coronary artery, lasting longer than three months. Once plaque has built up to the point of complete blockage, blood flow to the heart is compromised. If left untreated, CTO can lead to a slew of health issues including pain and fatigue, among others.

Who does CTO most likely affect?

CTO is most common in patients who have heart disorders, including coronary artery disease (CAD). For this reason, many patients with CAD also have a chronically blocked artery.

What are the risk factors of CTO?

Smoking, high cholesterol, diabetes, eating a diet high in fat and cholesterol, inactive lifestyle, high blood pressure, CAD, history of heart attack and obesity are all identified risk factors associated with CTO.

What are the symptoms of CTO?

Symptoms of CTO vary from patient to patient; some patients may even be asymptomatic with CTO while other may experience symptoms, often coinciding with periods of activity – for instance, symptoms may present stronger during a long walk or when while completing housework.

Symptoms of CTO may include:

  • Pain or discomfort in the chest
  • Shortness of breath
  • Dizziness
  • Fatigue
  • Nausea
  • Pressure or pain in the arm or upper body
  • Quickened, sporadic heartbeat

How is CTO diagnosed?

CTO diagnosis can be based on a few different measures, including a physical exam or X-ray imaging and confirmed with an EKG, stress test, PET scan, MRI or echocardiogram. A provider may order one or more of these tests to further understand an individual CTO case.

How is CTO treated?

CTO treatments have come a long way in recent years. Previously, treatments options for CTO either entailed medication or coronary artery bypass graft (CABG). Performing a CABG procedure requires surgery in which a vein or artery is removed from one area of the body and replaced near the CTO to create a new path for blood to flow. This method can be very effective in some patients, but recent innovations in treatments offer less invasive solutions for CTO patients.

The skilled interventional cardiologists at the Heart Hospital of New Mexico at Lovelace Medical Center (HHNM) are at the forefront of treatments and medical breakthroughs relating to CTO.

One of the most innovative and complex procedures used for the treatment of CTO is the percutaneous coronary intervention (PCI) procedure. Additionally, advancements include the antegrade approach, as well as the retrograde method, which has increased the success rate of CTO PCI in recent years. During this minimally invasive procedure, a small balloon is inserted through a catheter to open narrowed or blocked blood vessels in the heart (coronary arteries).

In February 2019, HHNM underwent reviews by accreditation specialists from the American Heart Association. In key areas HHNM exemplified the exceptional quality of care to receive accreditation included expertise, facilities and equipment to perform PCI and PCI readiness on a 24/7 basis.

If you believe you’re at risk of CTO, schedule today with one of the Interventional Cardiologists at the New Mexico Heart Institute/Lovelace Medical Group at Lovelace Medical Center at 505.727.2727.