What is a CTO — and can it really be fixed without surgery?
Chronic Total Occlusions are 100% blocked arteries that have been closed for months or years. Many patients are told nothing can be done — here's what modern CTO PCI actually offers.
A Chronic Total Occlusion (CTO) is a coronary artery that has been completely blocked for at least three months. Because the blockage is total and often hardened, standard angioplasty techniques frequently fail — which is why many patients are told their only options are bypass surgery or medication alone.
Why general cardiologists refer these cases out
Reopening a CTO requires specialised wires, microcatheters and — most importantly — high procedural volume. Success rates in dedicated CTO programs now exceed 90%, compared with 50–60% in centres that only occasionally attempt them.
What modern CTO PCI actually involves
We use a hybrid algorithm combining antegrade (from the front of the blockage) and retrograde (through collateral vessels) approaches. Intravascular imaging guides every stent, and calcium is modified with lithotripsy or rotablation where needed. Most procedures are performed through the wrist, and most patients are discharged the following day.
Is it right for you?
If you have persistent angina, breathlessness on exertion, or reduced quality of life — and you've been told your artery is untreatable — a second opinion from a dedicated CTO operator is worthwhile. Bring your most recent angiogram.