Doc Talk: New procedure opens totally blocked arteries

02/10/2014 12:00 AM

08/08/2014 10:21 AM

Wesley Medical Center is now offering a new procedure for heart patients who might not be candidates for open heart surgery. Percutaneous coronary intervention (PCI) is available for patients with chronic total occlusion, or CTO.

CTO is a serious, difficult-to-treat condition in which a patient’s artery is completely blocked. The blockages are typically large and solid, having been in place three months or longer, preventing circulation to parts of the heart.

I performed the first CTO procedure in south-central Kansas at Wesley in October.

During the procedure, we insert a catheter into the wall of the artery, go around a part of the artery that is completely blocked and then re-enter the artery using this new technique.

This can be done antegrade (following the original course of the artery) or retrograde (going in the back door through side branches). It restores blood flow to the area that was not receiving proper circulation.

Many patients with this type of blockage experience chest pain on a regular basis, which interferes with daily activities. By restoring blood flow, those symptoms can be reduced and heart muscle function may improve. The patients can experience a better quality of life and may have a better long-term outcome due to improved heart muscle function.

CTOs have historically been untreatable for many patients who could not tolerate coronary artery bypass surgery. Sixty percent of patients with CTOs are treated only with prescription drugs, with variable success.

PCI gives us an option that we never had before, using a less-invasive procedure to improve circulation in many patients who would not have other options for treating the blockage.

CTO symptoms can include angina or pain in the chest, upper body and arms; jaw pain; indigestion or a choking feeling; cold sweat; and unusual fatigue or exercise intolerance.

Risk factors include smoking or exposure to second-hand smoke, past heart attack, coronary artery disease, family history of heart disease, high cholesterol, being overweight, diabetes and high blood pressure.

If you have symptoms or risk factors, talk with your doctor.

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