We can help with chronic total occlusion (CTO) of the coronary arteries.

Northwestern Medicine Bluhm Cardiovascular Institute provides comprehensive care for patients with a coronary artery chronic total occlusion (CTO). This is the most severe form of coronary artery disease (CAD). We are here to help.


Have you or a family member been diagnosed with a CTO?

Our hearts receive blood through the coronary arteries. These two blood vessels branch down the left and right sides of the heart. They are the only sources of blood to the heart. This means that the heart needs them to work well. Coronary artery disease (CAD) occurs when plaque builds up in the artery walls, which compromises blood flow to the heart. CAD affects about 1.2 million Americans each year, leading to stroke and heart attacks. About one in five CAD patients has a coronary artery chronic total occlusion (CTO). This is the most severe form of CAD.

A CTO is the complete blockage of one or more of the coronary arteries with solid plaque (its density is compared to concrete). In most cases, it has been present for more than three months. Often, blood flow is severely compromised due to the blocked arteries. This causes the remaining arteries to detour blood to the compromised area by forming collaterals, or new arteries. This establishes blood flow to the heart.

Northwestern Medicine Bluhm Cardiovascular Institute offers a multi-disciplinary team of interventional cardiologists, who are experts in diagnosing and treating patients with CTOs. They offer an advanced, minimally invasive approach to treat these patients.

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.

Once the wires and tools 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.

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Whether you are experiencing symptoms that you do not understand, have already been diagnosed with CTO or are looking for a second opinion, Northwestern Medicine Bluhm Cardiovascular Institute offers comprehensive expertise to you and your loved ones at multiple convenient locations.

Bluhm Cardiovascular Institute at Northwestern Memorial Hospital
675 N. Saint Clair Street
Galter Pavilion, Suite 19-100
Chicago, IL 60611
312.NM.HEART (312.664.3278)

Bluhm Cardiovascular Institute at
Lake Forest Hospital 

1000 North Westmoreland Road
Main Entrance
Lake Forest, IL 60045
847.53.HEART (847.534.3278)

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Northwestern Memorial Hospital is ranked No. 12 in the U.S. for cardiology and heart surgery by U.S. News & World Report, 2021-2022. Our ranking is a reflection of the leading-edge services we offer and the results we achieve for our patients.

  • Highest ranked cardiology and heart surgery program in Illinois for 14 consecutive years
  • Highest available cardiology and heart surgery patient survival score since the metric was introduced
Northwestern Memorial Hospital 312.NM.HEART (312.664.3278)Lake Forest Hospital 847.53.HEART (847.534.3278)


McHenry Hospital 815.759.8070

Bluhm Cardiovascular Institute at McHenry Hospital
4201 Medical Center Drive
McHenry, IL 60050

Before PCI

After PCI

Before PCI

After PCI

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How is a CTO treated?

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Meet the Team

Keith H. Benzuly, MD

Keith H. Benzuly, MD
Interventional Cardiology

James D. Flaherty, MD

James D. Flaherty, MD
Interventional Cardiology

Tim S. Provias, MD

Tim S. Provias, MD
Interventional Cardiology

Asad Sheikh, MD

Asad Sheikh, MD
Interventional Cardiology

Daniel R. Schimmel, MD

Daniel R. Schimmel, MD
Interventional Cardiology