Chronic Total Occlusion Interventions

Ashchi Heart & Vascular Center PhotoAshchi Heart & Vascular Center offers a highly advanced innovative approach to treat patients with chronic total occlusion (CTO), called chronic total occlusion percutaneous coronary intervention (CTO PCI). CTO PCI is a minimally invasive procedure performed by experienced cardiac interventionalists with specialized training in advanced methods to treat CTO blockages; at present, only 1-2% of cardiac interventionalists in the U.S. can perform the full range of CTO PCI. In our practice, Sonny Achtchi, DO brings experience in performing CTO interventions for patients with complete blockages of the coronary arteries.



Understanding CTOs

CTOs are blockages that have typically been present for more than three months. These blockages are a result of severe build-up of fatty deposits or plaque within the arteries (atherosclerosis). Coronary artery disease occurs when the artery or arteries that supply blood to the heart become narrowed or blocked because of atherosclerosis. When the heart does not receive enough blood, a person may have chest pain (angina), shortness of breath or a heart attack. These symptoms occur with exertion and sometimes at rest.

CTOs occur in any part of the arterial vasculature. They commonly occur in the legs and in other arteries besides the heart. CTO interventions also benefit those with advanced peripheral arterial disease – which, like coronary artery disease, is caused by narrowing of the arteries.

Individuals with CTOs may experience the following symptoms:

  • Angina or chest pain, pressure or tightness
  • Shortness of breath
  • Dizziness
  • Fatigue
  • Nausea or indigestion
  • Pain in the upper body and arms, potentially concentrated on the left side
  • Jaw pain
  • Rapid or irregular heartbeat


If you have any of the following conditions, you may be at increased risk for coronary artery CTO:

  • Smoking or daily exposure to second-hand smoke, at home or at work
  • Past heart attack or known coronary artery disease
  • Family history of heart disease
  • High cholesterol
  • Postmenopausal status (women)
  • Taking birth control pills and smoking (women)
  • Being overweight
  • Diabetes
  • Hypertension (high blood pressure)
  • A sedentary or inactive lifestyle


Treatment ususally start with medications, but if your symptoms persist, you may be considered for bypass surgery or a catheter-based procedure. With the advancement of technology, interventional cardiologists now use specialized devices to gently steer guide wires and catheters across the blockages to restore normal blood flow. This procedure greatly reduces your recovery time and allows you to resume normal activities as soon as a week after the procedure.

To see whether you would be a candidate for the procedure, please call 904-222-6656 to schedule a consultation with Dr. Achtchi today.

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