Complex PCI including CTO and calcium modification

Why are some procedures more complex?

When heart arteries became completely blocked for a period of time (can be weeks, months, or years), it can be technically very challenging to open up the occlusion. These complex procedures require a special set of skills, equipment, and expertise to perform. Some blockages can become hardened with calcium, making balloon dilatation impossible. In such cases, special tools and techniques are required to perform successful stenting treatment.

Chronic total occlusion (CTO)

Dr Chai spent his training with some of the world-leading CTO experts and is fortunate to have accumulated experience in dealing with these complete occlusion using different techniques. There are many different approaches in dealing with these complex blockages.

If you require complex CTO treatment, Dr Chai will explain the rationale, strategy, procedural challenges, as well as potential risk with you in details. Sometimes, this may require more than one operator for your procedure, and Dr Chai may sometimes work with his expert colleagues together to tackle these complex blockages for you. 

Dr Chai and colleagues

For CTO PCI, it is common to require two routes of access to your heart arteries. This may include one or both of your wrists, and / or the top of the legs. The procedure can be longer than normal, and it could take up to 2 - 3 hours to perform. You will receive medication to help you relax during the procedure, and Dr Chai will ensure you are put at ease and remain as comfortable as possible throughout. 

Calcium modification

Heavily calcified blockages present another unique challenge. Dr Chai's has expertise in assessing the underlying composition and morphology of the narrowing using state-of-the-art intracoronary imaging - this allows careful assessment of distribution and depth of the calcium and facilitate the best use of appropriate special tools such as rotational atherectomy (rotablation), and the latest addition of the interventional toolbox - Shockwave intravascular lithotripsy (IVL) - to facilitate optimal stent deployment and long-lasting result.

Shockwave IVL for unexpandable stent
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