Coronary Artery Chronic Total Occlusion (CTO) Treatments 

Northwestern Medicine Bluhm Cardiovascular Institute uses many methods to treat CTO. Patients first are diagnosed with an angiogram. This test lets the healthcare team see the walls of their coronary arteries and the blood flow. Then, treatment often includes a minimally invasive procedure, a type of percutaneous coronary intervention (PCI). This reduces or removes the blockages in the coronary arteries.

During the CTO procedure, interventional cardiologists enter the patient’s body through a vessel near the groin or wrist. They use tiny wires (or catheters) and other minimally invasive tools to approach the CTO blockages. Standard PCI involves passing the wire through each blockage. But, CTO treatment involves guiding these wires and tools through microscopic layers of the arterial wall and around the blockage. In some patients, healthcare providers may use the collaterals (detours formed to carry blood to the compromised areas of the heart) to deliver the tools to the blockage.

Once the wires and devices are in place, your healthcare provider will use standard PCI techniques. They will inflate a balloon to displace the plaque. Then, they will add a stent (small mesh tube) to help keep the artery open. This normalizes blood flow.

CTO treatment is more involved and complex than standard PCI, but the procedure is still minimally invasive. In fact, patients often go home the next day. After the procedure, patients’ symptoms tend to improve.


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.