A growing number of patients with coronary artery disease (CAD) find themselves in need of stent PCI or coronary artery bypass graft surgery, but have been told they are too high-risk for complications that may occur during these procedures. Left without treatment options, these patients deal with worsening chest discomfort, shortness of breath, fatigue and heart failure.

To address this growing population of high-risk CAD patients, the interventional cardiologists at Northwestern Memorial Hospital have demonstrated outstanding clinical outcomes using an advanced catheter-based procedure called Complete Higher Risk Indicated Percutaneous Coronary Intervention (PCI) or CHIP to open blocked coronary arteries in the high-risk patient.

Advanced PCI techniques used during CHIP

Advanced PCI techniques used during CHIP include rotational, orbital and laser atherectomy (shaves away plaque from the vessel wall, especially calcified plaque), specialized antegrade and retrograde coronary artery chronic total occlusion (CTO) approaches and complex bifurcation stenting. After receiving CHIP, patients often experience dramatic improvement in symptoms, improved quality of life and less re-admissions to the hospital.

High-risk factors

A number of factors may lead to a patient being considered high-risk and a candidate for CHIP including:

• Advanced age
• History of disease including kidney disease, stroke or diabetes
• Location of CAD including left main or bifurcated disease
• Challenging plaque types including calcified or long lesions
• Coronary artery chronic total occlusion (CTO)
• Previous open heart surgery
• Advanced heart failure

Protected percutaneous coronary intervention

High-risk CAD patients that have also been diagnosed with advanced heart failure and/or severe heart valve disease are particularly vulnerable during the CHIP procedure due to a weakened heart muscle that compromises blood pressure and cannot pump blood efficiently to the body. The interventional cardiologists at Northwestern Memorial Hospital offer catheter based devices, like ventricular assist devices, to be used during CHIP to provide temporary support to the heart by assisting in moving blood through the body. Temporarily supporting the heart with a ventricular assist device during CHIP is referred to as protected PCI.

Meet the CHIP Team