Yes, 100% blocked arteries can be treated and many techniques exist nowadays.
If the artery can be opened up through the normal route of blood flow it is called “antegrade” technique and there are newer specialized kits available for this technique.
There are also techniques that have been developed in Japan over the years called “retrograde” technique which is a way of going through the blocked vessel in the reverse manner by approaching though other arteries.
Usually when a vessel is slowly blocked to 100% over the years the other arteries start to linkup with the blocked artery through bridges (small blood vessels) called “collaterals”.
However, the angiogram has to be carefully studied to check that these collaterals are large enough for equipment to reach the blocked artery.
In 100% blocked arteries, however, prior to treatment one has to establish that there will be a benefit from the procedure ie opening up the long blocked artery will help with symptoms by improving blood supply to the heart and improve function.
Currently we use nuclear imaging or cardiac MRI to establish that the heat muscle beyond the blockage is alive and is of sufficient amount to warrant what could be a long and expensive procedure.
One has also be realistic about the chances of successful angioplasty and this can be calculated nowadays with scores such as “J-CTO or PROGRESS-CTO” which indicate chances of success and also outcomes.
