What to Expect During Your CTO PCI Procedure

PCI procedures are performed in our cardiac cath lab and feature several steps.

If your doctor has recommended that you undergo a CTO PCI procedure (chronic total occlusion percutaneous coronary intervention), you’ll have many questions. Henry Ford Hospital is the most experienced medical center in Michigan and the upper Midwest for CTO PCI, and our program has achieved a 90 percent success rate – one of the highest in the world. We offer this procedure for completely blocked heart arteries and other complications of coronary artery disease, including angina.

Cardiac catheterization laboratory

Our experts perform all PCI procedures in our dedicated cardiac cath lab. This specialized examination and treatment room features sophisticated equipment and experienced staff who carry out procedures using catheters (thin, spaghetti-like tubes). These allow us to access your heart and surrounding structures through tiny incisions.

Before your CTO PCI procedure

As with any procedure, there are potential risks. Before you schedule your CTO PCI procedure, your Henry Ford physician will discuss these risks with you. Your care team also may give you other specific instructions in the days and weeks leading up to your procedure.

The night before your procedure:

• Do not eat or drink after midnight
• Some medications, such as blood thinners, require special instructions.
• Your care team will review these with you beforehand and will indicate whether you should stop taking any of your medications.
• For any regular medications that you are instructed to take, use only a small amount of water.

The day of your CTO PCI procedure

When you arrive at the hospital:

• You may have a temporary urinary catheter inserted into your body. This will help you be more comfortable during the procedure.
• You will also receive a sedative to relax you, but in most cases are not put to sleep.
• The interventional cardiologist will make a small incision in one of the arteries in your wrist, groin or another area, then insert small, temporary catheters, which are threaded through the artery under X-ray guidance to reach your heart. X-rays also are used to show the blockage in your arteries.
• Your interventional cardiologist then uses tiny wires, fed through the catheter tubes, to drill through or go around the plaque blockage.
• Once this has been completed, your interventional cardiologist performs a standard angioplasty. This involves inflating a small balloon inside your coronary artery and inserting a tiny metal stent (coil), which attaches to the artery wall and helps to keep it open.

After your CTO-PCI procedure

Most patients go home the next day. You will need a designated driver to take you home. After the procedure:

• You may have some discomfort, tenderness or bruising in the area where the catheter was inserted.
• Your interventional cardiologist will indicate when it is safe for you to drive again, which may be up to 48 hours.

Given that CTO PCI restores normal blood flow, you will likely notice some immediate improvement, which may include reduced chest pain, an increase in energy and improved breathing. However, it may take a few weeks to see additional improvement in your symptoms.

Follow-up

Your physician also will schedule a checkup for four to eight weeks after your procedure. Depending on your specific case, your physician also may recommend a heart rehabilitation program.