Conquering the Final Frontier: Saint Luke’s Mid America Heart Institute on the Forefront of Treating Total Chronic Occlusions

KANSAS CITY, Mo. (May 5, 2014) — Saint Luke’s Mid America Heart Institute interventional cardiologists are on the forefront of perfecting new minimally invasive approaches to treat chronic total occlusions (CTOs) – completely blocked arteries – which previously were deemed untreatable. 

One in five patients with plaque buildup has at least one completely blocked artery. These CTOs were previously treated with medications or bypass surgery. In the past, many cardiologists have been reluctant to attempt to treat with minimally invasive angioplasty due to the time, complexity, and historically low success rate – often only 50-60 percent.

J. Aaron Grantham, M.D., Saint Luke’s Mid America Heart Institute interventional cardiologist and director of the Cardiovascular Disease Fellowship Training Program, is one of a pioneering team which has developed an innovative hybrid angioplasty approach to CTOs, which has achieved a 90 percent success rate in restoring blood flow. Dr. Grantham and the Saint Luke’s interventional cardiology team have now performed more than 2,000 procedures and trained interventionalists from nine countries in this new hybrid approach.

On May 7-9, 2014, Saint Luke’s Mid America Heart Institute will host an international CTO workshop designed to bring together a team of five Japanese and five U.S. physicians to collaborate and perform CTO-angioplasty procedures and discuss potential improvements to the hybrid approach and teaching methods. Previously there existed three primary methods for opening total chronic occlusions:

• Entering the artery in the direction of the blood flow down to the blockage (antegrade)
• Working backward through the feeder vessels and approaching the blockage opposite of the blood flow (retrograde)
• Working around the blockage with a new dissection and re-entry device called the Bridgepoint System, developed by Boston Scientific Inc.

In the new hybrid methodology, interventional cardiologists are prepared to perform all three approaches during one procedure, which not only increases the likelihood of success but also reduces patients’ need for multiple surgeries, lengthy procedures, and increased costs.

“This is a fundamental change in how we approach treating these blockages,” said Dr. Grantham. “Research has shown an angioplasty attempt rate of only 13 percent. We are passionate about training physicians so they can achieve efficient CTO angioplasty results and substantially benefit their patients’ quality and even quantity of life.”

Saint Luke’s Mid America Heart Institute is currently the only center in Kansas City offering this hybrid methodology for treating CTOs.

Patients are selected for revascularization based upon their symptoms, risk, and response to medical therapy. Interventional cardiologists first review the patient’s angiogram, then determine which procedure to employ and in what order. If the first method is unsuccessful, the team then moves on to the second technique.

“Having multiple strategies to attack the blockage means we can help a much higher number of patients,” said Dr. Grantham. “We can treat anyone, no matter how long the blockage and no matter how calcified the blood vessel, and still achieve excellent results.”

This approach requires the expertise of interventionalists, who are trained physicians technically adept at catheter procedures in the catheterization lab. Saint Luke’s Mid America Heart Institute boasts a long history of internationally recognized expertise in interventional cardiology. The program is among the world’s largest and frequently hosts workshops to educate cardiologists around the globe in leading-edge procedures.  

Dr. Grantham recently received a three-year research grant from Boston Scientific to investigate and better define the success, safety, health benefits, and cost-effectiveness of novel methods to open challenging blocked coronary arteries previously thought untreatable through minimally invasive techniques.

Saint Luke’s Mid America Heart Institute

Saint Luke’s Mid America Heart Institute, a member of Saint Luke’s Health System and a teaching affiliate of the University of Missouri-Kansas City, is one of the preeminent cardiovascular programs in the country. Its legacy of innovation began more than 25 years ago when it opened as the nation’s first heart hospital. Since then, the Heart Institute has earned a worldwide reputation for excellence in the treatment of heart disease, including interventional cardiology, cardiovascular surgery, imaging, heart failure, transplant, heart disease prevention, women’s heart disease, electrophysiology, outcomes research, and health economics. With more than 50 full-time board-certified cardiovascular specialists on staff, the Heart Institute offers one of the largest heart failure/heart transplant programs in the country, has the broadest experience with transcatheter aortic valve replacement in the Midwest, and is a global teaching site for the newest approaches to opening challenging blocked arteries using minimally invasive techniques.