- Echo
- ECG
- Holter monitor
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In-clinic Echo, ECG & Holter monitor
Echocardiography, ECG and Holter monitoring are done right at the clinic, so your tests and your consultation happen in one place.
Advanced coronary interventions
Complex Coronary Interventions & Chronic Total Occlusion (CTO)
Advanced techniques for calcified, long-blocked, or previously "inoperable" arteries
You don't have to face this decision alone. At your consultation, Dr. Mansour explains every image and every option to you and your family in plain words — and stays with you until you're back to your life.
- Consultation 1,000 EGP · pay at the clinic
- Free follow-up visit within 14 days
- Your reports stay private
Rotational Atherectomy & Complex PCIMinimally invasive — no open-heart surgery
Dr. Mansour Farouk El-BehwashyConsultant Cardiologist & Cardiovascular SpecialistMScFEBFEBICFSCAIProcedure time1–3 hours
- Procedure time1–3 hours
- AnesthesiaLocal anesthesia + sedation
- Hospital stay1–2 nights
- Gradual return to activity1–2 weeks
What the procedure is
Understand Rotational Atherectomy & Complex PCI — calmly, clearly, honestly
Not every blockage responds to a standard balloon and stent. Heavily calcified plaque can resist expansion; a chronic total occlusion (CTO) — an artery blocked for three months or longer — may have no visible channel for a wire to cross at all. These cases used to mean referral for open-heart bypass surgery.
As a Fellow of the Society for Cardiovascular Angiography and Interventions (FSCAI), Dr. Mansour Farouk El-Behwashy uses a set of specialized techniques for exactly these arteries: rotational atherectomy (a rotating burr that sands down hard calcium), intravascular lithotripsy — IVL (sonic pressure waves that crack calcium deposits without harming soft tissue), cutting balloon angioplasty (micro-blades that score resistant plaque before it's widened), and dedicated CTO-crossing techniques to reopen arteries that have been fully blocked for months or years.
Why it may be recommended
What it can mean for you — and your peace of mind
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Treats arteries that standard angioplasty alone cannot open
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A genuine, minimally invasive alternative to bypass surgery for many previously "inoperable" cases
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Can meaningfully relieve angina and improve exercise tolerance even in long-standing blockages
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Performed by a fellowship-trained interventional cardiologist with dedicated CTO/complex-PCI experience
Who may need evaluation for it
Does any of this sound like you?
Tap whatever applies. It isn't a diagnosis — just a calm way to know whether it's time to talk to the doctor.
Chest pain right now, fainting or sudden breathlessness? Don't wait — go to the nearest emergency department or call 123.
Nothing selected yet — tap any line that applies to you.
Step by step
Your journey, with no surprises
Knowing what comes next takes away most of the fear. Here is what to expect before, during and after — explained to you again, in person, before anything is done.
Something here worrying you?
Ask the clinic — the team replies on WhatsApp.
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Before
General preparation
- Bring every previous report you have — ECGs, echo results, stress tests, lab work and any catheterization CDs.
- Share a full list of your medications, especially blood thinners and diabetes medicines, and any allergy — including to contrast dye or iodine.
- Routine blood tests, such as kidney function and a blood count, are usually requested beforehand.
- You will usually be asked not to eat for a few hours before the procedure — follow the exact fasting instructions you are given.
- Plan for someone to accompany you and take you home afterwards.
- Never stop or change a medication on your own — any adjustment is decided by your doctor.
Your care team gives you instructions specific to your case — always follow those first.
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On the day
What happens during the procedure
- A detailed review of your prior imaging and catheterization results to plan the specific technique needed.
- Access through the wrist (or, when needed, both wrist and groin for CTO cases requiring a dual approach).
- Specialized wires and, where indicated, rotational atherectomy or intravascular lithotripsy prepare the calcified or blocked segment.
- The artery is opened with balloon angioplasty and one or more stents once the segment is adequately prepared.
- Extended imaging confirms full restoration of blood flow before the procedure ends.
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After
Recovery & follow-up
- Longer procedures mean a longer observation period — typically 1–2 nights in hospital
- More extensive bruising at the access site is normal and settles over 1–2 weeks
- Activity is increased gradually, guided by your follow-up visits
- A structured medication plan (including dual antiplatelet therapy) is set to protect the treated segment
Clinic features
Care that continues after your visit
14days
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FREE consultation within 14 days
After your examination, your follow-up consultation within 14 days is free of charge.
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Continuous follow-up & answers
Questions after your visit or procedure? We keep following up with you and answering them along the way.
Honest about safety
Risks & considerations
Every medical procedure carries some risk, and you deserve the full picture. Dr. Mansour reviews your personal risk with you before you agree to anything.
- All the general risks of coronary angioplasty (bruising, bleeding, contrast reaction)
- A somewhat higher, procedure-specific risk profile than standard PCI, given the complexity of the artery being treated
- A small chance a CTO cannot be fully crossed in one sitting, requiring a planned second attempt
- Dr. Mansour Farouk El-Behwashy reviews the specific risk/benefit balance for your artery before proceeding
This page is general information and does not replace a medical examination. Whether this — or any — procedure is appropriate for you is decided only after evaluation by the doctor.
Already advised?
Told you need this procedure? Get clarity before you decide.
Send your reports from your phone in a few minutes. Dr. Mansour's team reviews them before your visit, so your consultation at the Fifth Settlement clinic starts with answers — not from zero.
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Private consultation · 1,000 EGP · Fifth Settlement, New Cairo
- 1Upload your reports
- 2The team reviews your case
- 3Your consultation, fully prepared
Your questions
Frequently asked questions
Still have a question on your mind?
Ask the clinic directly — no need to call. The team replies to you on WhatsApp.
I was told my blockage can only be fixed with open-heart surgery — is that always true?
Not always. Many arteries once considered surgery-only — heavily calcified vessels, chronic total occlusions — can now be treated through the wrist with advanced techniques like rotational atherectomy, IVL, and dedicated CTO crossing. Bring your reports for a specific review of whether that applies to your case.
What is a chronic total occlusion (CTO), exactly?
It's a coronary artery that is 100% blocked and has been that way for at least three months. The heart often develops small natural detour vessels around it, but the original artery itself stays closed unless specifically reopened with dedicated CTO techniques.
Why would I choose this over bypass surgery?
When it's a suitable option for your specific artery, it avoids opening the chest, general anesthesia, and the multi-week recovery of bypass surgery — replacing it with a catheter-based procedure and a hospital stay measured in days. Whether it's the right choice depends on the exact anatomy of your blockage, which is assessed on catheterization.
Clinical references
Related procedures
Angioplasty & Stenting
A tiny balloon widens the narrowed section of a coronary artery, and a stent — a small mesh tube — is left in place to keep it open, restoring blood flow to the heart muscle in the same sitting as the diagnostic catheterization.
May be considered
When catheterization shows a significant narrowing, or angina continues despite medication.
Cardiac Catheterization
A thin catheter is guided to the heart through the wrist or groin to map the coronary arteries with live X-ray imaging — the test that confirms whether, and where, a blockage exists.
May be considered
When symptoms such as chest pain or breathlessness — or an abnormal ECG, stress test or CT scan — call for a definitive look at the coronary arteries.
Peace of mind starts with one step
Don't carry this worry alone. Let's look after your heart together.
Consultation 1,000 EGP at the Fifth Settlement clinic, New Cairo — paid at the clinic, with a free follow-up visit within 14 days.
Chest pain right now, fainting or sudden breathlessness? Don't wait — go to the nearest emergency department or call 123.