Chronic total occlusion (CTO)

UF Health’s experienced interventional cardiology team offers percutaneous coronary intervention (PCI) for patients with coronary artery chronic total occlusion (CTO).

CTO refers to the complete blockages in coronary arteries that develop over a prolonged period of time and can often lead to collaterals, or conduits in between coronary arteries without intervening capillary beds, that provide alternate routes for blood supply.

Subsequently, patients with CTO may develop symptoms varying in severity and character associated with myocardial ischemia, including fatigue, chest pain, dyspnea, neck or arm pain, malignant heart rhythm, heart failure and more.

Traditionally, CTO patients are relegated to medical therapy or to coronary artery bypass grafting (CABG) surgery as PCI had a limited role in treatment. Frequently, medical therapy may not provide adequate symptom relief, and CABG may not be an option for older patients and patients with comorbidities. Consequently, a number of patients with CTO experience symptoms refractory to conventional medical therapy and did not have viable treatment options.

The success rate for CTO PCI is 80-90% in suitable patients.

Successful CTO PCI may relieve symptoms associated with myocardial ischemia, improve heart function, exercise capacity and quality of life. At UF Health, we can provide PCI as an option for patients with CTO who otherwise would suffer from debilitating symptoms due to myocardial ischemia.

For more information, call 352.265.0820.

Calvin Choi, MD
Dr. Calvin Choi – one of the members of the interventional cardiology team.


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Right coronary artery chronic total occlusion percutaneous coronary intervention (RCA CTO PCI)

RCA CTO – angiogram shows chronic total occlusion of right coronary artery.

Dual injection – simultaneous left and right coronary artery angiogram shows chronic total occlusion of right coronary artery and collateral from left anterior descending artery

Reverse CART, wire externalization and IVUS – successful reverse CART, wire externalization and IVUS.

Finish – angiogram shows successful right coronary artery chronic total occlusion percutaneous coronary intervention.