Coronary Artery Chronic Total Occlusion (CTO) Treatments 

Multiple technologies can treat coronary artery chronic total occlusion (CTO). Patients are first are diagnosed with CTO by using an angiogram to view the walls of their coronary arteries and blood flow. Then, the best course of action is determined.

For many patients with CTO, this means a minimally invasive procedure, a percutaneous coronary intervention (PCI), to reduce or eliminate blockages. In a PCI, a non-surgical procedure, a catheter (a thin flexible tube) is used to place a stent to open up blood vessels in your heart.

During the procedure, the physician, through a small incision near the patient’s groin or wrist, uses tiny specialty wires and other minimally invasive devices, to approach the CTO blockage(s) of your heart. Unlike typical PCI, which includes passing the wire through a narrow opening in the artery, CTO treatment often involves guiding these specialty wires and devices through or around the blockage within the artery wall.

Once wires are in place, conventional PCI techniques are then used: a balloon is inflated to displace the plaque and a stent (small mesh tube) is added to help keep the artery open, normalizing blood flow.

While CTO treatment is more involved and complex than typical PCI, the procedure is still minimally invasive and patients often return home the following day. After the CTO procedure, instead of suffering with lower activity levels and diminished quality of life, patients frequently enjoy a dramatic reduction of symptoms.

Men and women experiencing CTO with symptoms of angina (a type of chest pain caused by reduced blood flow to the heart muscle)—who have an abnormal stress test and continue to be symptomatic despite medical therapy—may be candidates for this specialized treatment.


Several advanced, minimally invasive technologies are available for treating coronary artery chronic total occlusion (CTO).

Meet the Coronary Artery Chronic Total Occlusion Teams

Northwestern Medicine Bluhm Cardiovascular Institute is a nationally recognized destination for those who require highly specialized cardiovascular care.