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What is a CTO lesion in heart? #bestcardiologistkolathur #bestcardiologistperambur

A Chronic Total Occlusion (CTO) lesion is a complete or nearly complete (100%) blockage of a coronary artery that has existed for three months or longer, typically presenting with TIMI 0 flow. These complex, long-term lesions often feature hardened plaque, dense collagen, and are treated through specialized, advanced percutaneous coronary intervention (PCI) to improve symptoms of angina and quality of life. . These complex, long-term lesions often feature hardened plaque, dense collagen, and are treated through specialized, advanced percutaneous coronary intervention (PCI) to improve symptoms of angina and quality of life.

Key aspects of CTO lesion

Definition & Characteristics: A "true" CTO shows 100% occlusion for more than 3 months

It is characterized by the absence of an obvious, recent acute event, with blood flow to the downstream artery often supplied by collateral vessels.

3Pathology:Older lesions are often composed of dense collagen or fibrous material. They may show negative remodeling (shrinkage of the vessel

Symptoms & Diagnosis: Symptoms include angina, chest pain, or dyspnea. Diagnosis is confirmed via coronary angiography, which often reveals significant collateral circulation.
Pathology: Older lesions are often composed of dense collagen or fibrous material. They may show negative remodeling (shrinkage of the vessel)

Treatment options

CTO PCI : An advanced interventional technique using specialized wires and catheters to recanalize the vessel. Techniques include antegrade or retrograde approaches, often aided by dual coronary angiography.
CABG : Coronary artery bypass grafting is used for severe or multi-vessel disease.

Success in treating CTO depends on the lesion length, presence of calcium, and the operator's experience with techniques like the parallel wire technique to navigate the occlusion.

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August 2023

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