Leaders in CTO percutaneous coronary interventions

Ascension Indiana St. Vincent heart doctors treats chronic total occlusions with innovative PCI procedures.

Chronic Total Occlusion Care

Coronary artery chronic total occlusion (CTO) is a coronary artery that has been completely blocked for three months or longer. Coronary CTO is caused by a heavy buildup of plaque within the artery.

Signs may include:

  • Angina, which is chest pressure, tightness or discomfort
  • Shortness of breath
  • Fatigue or “wearing out” too quickly
  • Pain in the upper body and arms, potentially concentrated on the left side
  • Jaw pain
  • Indigestion or choking feeling
  • Nausea
  • Dizziness or light-headedness
  • Cold sweat
  • Rapid or irregular heartbeat

Treating Chronic Total Occlusion

Restoring blood flow to a vessel blocked with a CTO may significantly improve a patient’s quality of life by providing symptom relief and improved heart function. Successful treatment of CTOs may allow a patient to avoid coronary artery bypass graft surgery (CABG).

Ascension St. Vincent is proud to have the largest and most successful CTO program in the region. The number of procedures we do and our success rate place us in the top tier of national programs.

Doctors Jarrod Frizzell, Michael Kourany, and Charles Orr are interventional cardiologists who specialize in the treatment of CTOs and other complex, high-risk interventional procedures. Dr. Frizzell is the only CTO-trained cardiologist in the Evansville region, and performs these procedures in Evansville and Indianapolis. Doctors Kourany and Orr are based in Indianapolis.

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The CTO Procedure

During the CTO procedure, a long thin tube called a catheter is inserted in your wrist or groin and threaded through your blood vessels to your heart, like a heart catheterization. Unlike a normal stent procedure, treatment of CTOs often involves placing two catheters, because of how complex the blocked artery is. Recovery is otherwise similar to a regular heart catheterization.

CTO Percutaneous Coronary Intervention (PCI) Benefits and Goals

Patient benefits include:

  • Improved angina
  • Improved exercise capacity
  • Improved quality of life

The likelihood of success is dependent on operator experience/volume of procedures completed.

Risks to consider include:

  • Acute Risks:
    1. Emergency coronary artery bypass graft
    2. Myocardial infarction (heart attack) around time of procedure
    3. Pericardial tamponade (extra fluid builds up in the sac around the heart, preventing it from beating normally)
    4. Renal (kidney) failure
    5. Stroke
    6. Vascular access complications (infection, blood clot, etc.)
  • Chronic Risks:
    1. Stent thrombosis (blood clot)
    2. In-stent restenosis (plaque recurs within placed stent)
    3. Radiation skin injury on back of patient from procedure

Ascension St. Vincent Heart Center is ranked highest by CMS among other top hospitals.

To learn more about chronic total occlusions, please call 812-473-2642 for our Evansville, IN location, or 317-338-6666 for our location in Indianapolis, IN.