Whenever there is an obstruction or blockage in the coronary arteries, it hinders the oxygen-rich blood flow to the heart muscles, resulting either in angina (chest pain) or myocardial infarctions (heart attacks). In some cases, the blockage occurs more slowly so that collateral circulation starts to take up the role of coronary arteries. In medical terms Coronary chronic total occlusion is defined as – “a complete blockage of the coronary artery with TIMI (Thrombolysis in Myocardial Infarction) zero flow present for an estimated duration greater than or equal to three months”. Chronic Total Occlusion (CTO) is often found in patients with significant coronary artery disease (CAD), presenting a management dilemma for interventional cardiologists.
Coronary artery chronic total occlusion which occurs due to the deposit of fibrocalcific plaque is one of the most commonly identified lesion subsets in CAD patients. Revascularization of CTO can offer varied benefits as it provides improved heart function and reduced risks of arrhythmic events. Intricate pathophysiology of organized fibrocalcific atherosclerotic plaque which makes it difficult to cross with guide –wire increases the complications of percutaneous approach for CTOs. A promising solution to this guide-wire problem was the delivery of radiofrequency energy through the catheter guide wire that can burn off the blockage. Similar to the novel latest Thermocool Smarttouch Catheter, this method allows the interventional cardiologist to ablate the atherosclerotic plaque without causing any injury to the wall of the coronary artery. As the latest Thermocool Smarttouch Catheter is mainly used during the cardiac ablation procedure, the safe-cross-guided radiofrequency total occlusion crossing system allows the physician to clear out the CTO blockage to perform percutaneous coronary intervention (PCI).
Another risk factor that can increase the chances of major acute cardiovascular events among the CAD patients is the presence of resistant hypertension. As the name implies, it is a medical condition when the blood pressure remains stubbornly high despite medical treatment. Promising results from the novel barostim therapy presents new hope to the medical community. Reducing the excessive blood pressure and improving cardiovascular function by a great extent, barostim neo implantation and therapy is projected to be an ideal choice for treating resistant hypertension. Novel barostim therapy can reduce the likelihood of adverse cardiovascular events thereby improving the quality of life.
