Complex Coronary Therapeutics Program

Overlake’s Complex Coronary Therapeutics Program is among a select few in the region offering advanced interventional procedures for patients with chronic total occlusions (CTOs) and other types of complex coronary artery disease. These procedures can offer a less-invasive alternative to open-heart surgery.

Cardiologists use interventional procedures to diagnose and treat cardiovascular conditions by using catheters (thin, flexible tubes), special types of wires, and tiny devices (such as balloons and stents) to open blockages in heart arteries, instead of opening the chest. Our program is overseen by Robert Riley, MD a renowned expert who was one of the nation’s first cardiologists to complete fellowship training in complex interventional procedures.

This means you receive care from a physician who has the highest level of experience, education and training. Overlake is among a select handful of hospitals where you can access this specialized expertise. This significantly increases your chances of a good outcome and improved quality of life, even if your condition is considered high-risk and complex.

Advanced treatments for complex coronary artery disease

At Overlake, our team has the expertise to use an approach called percutaneous coronary interventions (PCIs) to help patients overcome CTOs and other complicated artery blockages. With PCIs, we open up severely narrowed arteries without the need for open-heart surgery to create a bypass around the blockage.

During PCI, an Interventional Cardiologist:

• Makes a small incision in the groin or wrist to access a blood vessel.
• Guides a catheter through that blood vessel to reach the blockage.
• Inserts a wire through the catheter and across the lesion. 
• Uses special drills, ultrasound waves, or different types of balloons in the narrowed artery to open it up.
• Places a stent (wire mesh tube) to permanently keep the artery open, allowing blood to flow more freely to the heart.

This approach enables many patients to improve their health and quality of life. Patients enjoy faster recoveries, with less time in the hospital.

Dedicated care for high-risk patients with complex needs

Chronic total occlusions (CTO) are a severe form of coronary artery disease that happens when fatty deposits or plaque create a near 100% blockage of one or more coronary arteries that carry blood to the heart. This blockage causes chronic chest pain, shortness of breath and fatigue.

It's not uncommon for hospitals to turn away patients with these blockages because they have:

• Risk factors that make open-heart surgery risky. This includes having had open-heart surgery in the past.
• Blockages that are heavily calcified, which means they can be harder to open.
• Blockages in more than one artery.

Our team, led by Dr. Riley, can help even the most complex patients. Many patients come to us after another hospital has told them they are too high-risk. We take pride in doing our best to help every patient who comes through our doors. 

Team care, tailored to you

Before joining Overlake, Dr. Riley spearheaded one of the nation’s largest complex coronary therapeutics programs. There, he achieved an almost 90% success rate using PCI to open complex blocked arteries. Patients reported significant decreases in symptoms while enjoying dramatic improvements in quality of life.

At Overlake, Dr. Riley is part of a team of heart specialists that understands each patient is unique. Our team approach brings together doctors in several specialties to understand your needs. We carefully review your medical history and evaluate your condition. Then we work together to consider all your options—including medications, surgeries and interventional procedures—and create a treatment plan that is tailored to you and gives you the best opportunity for a good outcome.

Overlake is one of three regional hospitals recognized by the Cardiac Care Outcomes Assessment Program for superior performance for patients undergoing coronary angioplasty. This program monitors the quality of adult cardiac care across hospitals in the Pacific Northwest.