Coronary Interventions High Risk – CHIP

Some patients find themselves without treatment options as their disease progresses and they become too high risk for treatment.  The highly skilled physicians at Augusta University Medical Center use a wide range of techniques to treat these complex cases.

Providers at Augusta University Medical Center offer a highly complex approach to treatment of coronary artery disease (CAD). When CAD is present, coronary arteries become blocked or narrowed, limiting the flow of blood to the heart muscle.  Often times this narrowing is caused by plaque buildup, which is so dense the normal technology and supplies used during cardiac catheterization and percutaneous coronary intervention will not work. 

Chronic Total Occlusions (CTO)

A Chronic Total Occlusion or CTO is a complete blockage of coronary artery with a solid plaque. This is a chronic or long standing condition, once this occurs the heart will build collateral arteries to detour around the blockage in an attempt to provide blood to the heart. Symptoms include:

  • Chest pain or tightness
  • Shortness of breath
  • Fatigue
  • Pain in the upper arm or jaw
  • Nausea
  • Dizziness

Patients than may benefit from treatments of CTO’s are those that still experience symptoms of CAD after multiple procedures including stenting and coronary artery bypass graph (CABG) or open-heart surgery.  Other patients that may benefit from CTO procedures are those that have been told there is nothing else that can be done to alleviate the symptoms.

Treatment of CTO’s is similar to other percutaneous coronary interventions using stents and balloons except the providers skills and supplies are different.  CTO’s are open in the cardiac cath lab much like that of a percutaneous coronary intervention.  After the CTO is opened, a stent is placed to hold the artery open.

Interventions on CTO’s require providers with advanced skills and technology.  The specially trained interventional cardiologists at AUMC are leaders in their field and here to provide superior care. Our providers will collaborate with you to determine your best course of treatment.


Almost 15% of people who have had their coronary disease treated with a stent may experience blockage inside the stent or restenosis. When this happens, you may experience the same symptoms you had before the stent was placed. Our expert cardiologists may recommend brachytherapy for you.

Brachytherapy is commonly used to treat cancers, but can also be used to treat narrowing arteries inside coronary stents.T here are only a few hospitals in the US that use this treatment. Augusta University Medical Center is the only hospital in the area that offers intravascular brachytherapy.

Brachytherapy is a minimally invasive procedure where a radioactive seed is implanted beside the plaque which is limiting blood flow. Treatment plans for restenosis are very individualized. Our expert Interventional cardiologist will discuss the treatment options best for you.