A Chronic Total Occlusion (CTO) is a complete blockage of a coronary artery that has persisted for at least three months. This condition is caused by atherosclerosis, which restricts blood flow to the heart and can lead to symptoms like chest pain or shortness of breath, though some patients may be asymptomatic due to collateral blood flow. Treatment options include medication, catheter-based procedures like angioplasty with stenting, or bypass surgery.