Kolkata, 2 November 2025: A 59-year-old male patient underwent a highly complex CTO-angioplasty using IVUS guidance at Manipal Hospital, Broadway, under the supervision of Dr Norihiro Kobayashi, renowned Interventional Cardiologist from Yokohama City Hospital, Japan. The patient was admitted under Dr Arijit Ghosh, HOD – Interventional Cardiologist, Manipal Hospital, Broadway with complaints of chest pain on exertion. Coronary angiography revealed a critical blockage in the left coronary artery and a 100% blockage in the right coronary artery, a condition known as Chronic Total Occlusion (CTO).
CTOs develop gradually over several years and are among the most difficult coronary blockages to treat. Due to the dense and hardened nature of the block, many patients are advised to undergo bypass surgery. However, advancements in interventional cardiology now allow select CTOs to be treated through minimally invasive angioplasty using specialised tools, such as Intravascular Ultrasound (IVUS) and micro-guidewires, requiring exceptional precision and expertise.
The procedure was performed at Manipal Hospital, Broadway during a complex coronary workshop by Dr Kobayashi as the international proctor, along with the Cath Lab team at the hospital, led by Dr Subhasis Roy Chowdhury, Director – Cath Lab, Manipal Hospital, Broadway. The team was able to open the totally blocked artery with advanced hardware, IVUS imaging and specialized wires. The patient has responded well and is likely to be discharged within a day, a big advantage of this over conventional bypass surgery.
Sharing his experience, Dr Subhasis Roy Chowdhury, Director – Cath Lab, Manipal Hospital, Broadway said, “CTO interventions are among the highest-level cardiac procedures performed in catheterization labs around the world. The success of this case highlights how use of cutting-edge technology and expert collaboration can alter the course of treatment in patients who would otherwise have to undergo open-heart surgery. With IVUS-guided and advanced wires, we could navigate and open the arteries that were hitherto considered impassable by angioplasty."
Dr Arijit Ghosh, HOD – Interventional Cardiologist, Manipal Hospital, Broadway said, “When a patient comes with a completely blocked artery, the fear of open-heart surgery is natural. Being able to treat him through angioplasty, without opening the chest, and seeing him recover so quickly is deeply rewarding. The presence of Dr Norihiro Kobayashi and his insights on CTO techniques played a significant role in refining our approach. Such international collaborations strengthen our capabilities and allow us to offer cutting-edge treatment options to our patients right here in Kolkata.”
During the workshop, Dr Kobayashi also shared that in Japan, the number of bypass surgeries has significantly reduced in recent years, as interventional cardiology has become highly advanced and the preferred choice for most patients due to lower complication rates and much faster recovery.
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