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 blood vessels branch down the left and right sides of the heart. They supply the only sources of blood to the heart muscle. Coronary artery disease (CAD) occurs when plaque builds up in the coronary artery walls, which decreases 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 – decreasing blood flow to the heart muscle. In most cases, the complete blockage has been present for more than three months.

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 CTO.

Treatment for CTO includes a minimally invasive procedure, a type of percutaneous coronary intervention (PCI). This reduces or removes the blockages in the coronary arteries.

During the treatment for CTO, interventional cardiologists enter the patient’s body through a blood vessel near the groin or wrist. They use tiny wires (or catheters) and other minimally invasive tools to approach the CTO blockages in the heart. A standard PCI procedure involves passing the wire through each blocked coronary artery. Treatment for CTO involves guiding the wires and tools through the microscopic layers of the coronary artery walls, around each blocked coronary artery.

Once the wires and tools are in place, the interventional cardiologist will use standard PCI techniques to reduce or remove the blockages in the coronary arteries. They will inflate a balloon to displace the plaque and add a stent (small mesh tube) to help keep the artery open.

Treatment for CTO 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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Make an Appointment

Whether you are experiencing symptoms that you do not understand or have already been diagnosed with CTO and 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) (TTY:711)

Bluhm Cardiovascular Institute 
at Lake Forest Hospital 
1000 North Westmoreland Road
Main Entrance
Lake Forest, IL 60045
847.53.HEART (847.534.3278) (TTY:711)

Northwestern Memorial Hospital is ranked as a top ten program in the nation (No. 7) for cardiology, heart & vascular surgery by U.S. News & World Report, 2023-2024. Our impressive U.S. News & World Report achievements are a reflection of the expert care provided and why patients choose to get their heart and vascular seconds opinions from Northwestern Medicine.

  • Highest ranked cardiology, heart & vascular surgery program in Illinois for 16 consecutive years
  • Highest available cardiology, heart & vascular surgery patient survival score since the metric was introduced
  • Rated “High Performing” (the highest rating possible) for abdominal aortic aneurysm repair, aortic valve surgery, heart attack, heart failure and transcatheter aortic valve replacement (TAVR)
Northwestern Memorial Hospital 312.NM.HEART (312.664.3278)Lake Forest Hospital 847.53.HEART (847.534.3278)


USNWR Best Hospitals - Heart & Vascular, 2023-24
McHenry Hospital 815.759.8070

Bluhm Cardiovascular Institute 
at McHenry Hospital
4201 Medical Center Drive
McHenry, IL 60050
815.759.8070 (TTY:711)

Before PCI

After PCI

Before PCI

After PCI

How is a CTO treated?

Northwestern Medicine CTO Featured Publications

  1. Nikolakopoulos I, Vemmou E, Karacsonyi J, Alaswad K, Karmpaliotis D, Abi Rafeh N, Schimmel D, Benzuly K, Flaherty JD, Brilakis ES. 2022. Percutaneous coronary intervention of chronic total occlusions involving a bifurcation: Insights from the PROGRESS-CTO registry. Hellenic J Cardiol. 66:80-83. doi: 10.1016/j.hjc.2022.02.005.
  2. Yarusi BB, Jagadeesan VS, Hussain S, Jivan A, Tesch A, Flaherty JD, Schimmel DR, Benzuly KH. 2022. Combined Coronary Orbital Atherectomy and Intravascular Lithotripsy for the Treatment of Severely Calcified Coronary Stenoses: The First Case Series. J Invasive Cardiol. 34(3):E210-E217.
  3. Yarusi BB, Jagadeesan VS, Jivan A, Unger ED, Van Assche LMR, Provias TS, Flaherty JD, Benzuly KH, Schimmel DR. 2021. The Utility of Peripheral Intravascular Lithotripsy in Calcific Coronary Artery Disease: A Case Series. J Invasive Cardiol. 33(4):E245-E251.
  4. Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Krestyaninov O, Khelimskii D, Schimmel DR, Brilakis E. 2022. In-hospital outcomes and temporal trends of percutaneous coronary interventions for chronic total occlusion. EuroIntervention. doi: 10.4244/EIJ-D-22-00599.
  5. Kostantinis S, Simsek B, Karacsonyi J, Davies RE, Benton S, Nicholson W, Schimmel DR, Brilakis ES. 2022. Intravascular lithotripsy in chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry. Catheter Cardiovasc Interv. 100(4):512-519. doi: 10.1002/ccd.30354.
  6. Use of Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention.
    Karacsonyi J, Deffenbacher K, Benzuly KH, Flaherty JD, Alaswad K, Basir M, Megaly MS, Jaffer F, Doshi D, Poommipanit P, Khatri J, Patel M, Riley R, Sheikh A, Wollmuth JR, Korngold E, Uretsky BF, Yeh RW, Chandwaney RH, Elguindy AM, Tammam K, AbiRafeh N, Schmidt CW, Okeson B, Kostantinis S, Simsek B, Rangan BV, Brilakis ES, Schimmel DR.Am J Cardiol. 2023 Feb 15;189:76-85. doi: 10.1016/j.amjcard.2022.10.049. Epub 2022 Dec 10.PMID: 36512989

Meet the Team

Northwestern Medicine Bluhm Cardiovascular Institute is a nationally recognized destination for those who require highly specialized heart and vascular care.

Bluhm Cardiovascular Institute 
at Central DuPage Hospital
25 North Winfield Road
Winfield, Illinois 60190
630.938.3734 (TTY:711)

Bluhm Cardiovascular Institute 
at Palos Hospital
12251 South 80th Avenue, Suite 1520
Palos Heights, Illinois 60463
708.923.4200 (TTY:711)

Central DuPage Hospital 630.232.0280Palos Hospital 708.923.4200