34808 Endovascular placement of iliac artery occlusion device (List separately in addition to code for primary procedure)

Name of the Procedure:

Endovascular Placement of Iliac Artery Occlusion Device

Summary

Endovascular placement of an iliac artery occlusion device is a minimally invasive procedure performed to block blood flow in the iliac artery. This involves threading a catheter through a blood vessel to the iliac artery and deploying a device that occludes the blood flow.

Purpose

This procedure is typically done to prevent blood flow to a damaged section of the iliac artery or to stop bleeding. It aims to ensure that blood does not circulate through a problematic section of the artery, reducing the risk of severe complications such as aneurysms or hemorrhage.

Indications

• Aneurysms in the iliac artery
• Severe arterial bleeding
• Arteriovenous malformations
• Pre-surgical preparation for certain abdominal or pelvic surgeries

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Adjustment or discontinuation of certain medications, such as blood thinners.
• Pre-procedure diagnostics might include blood tests, imaging studies like an MRI or CT scan, and a detailed medical history assessment.

Procedure Description

1. The patient is typically given local anesthesia and possibly light sedation.
2. A small incision is made in the groin area.
3. A catheter is inserted into the blood vessel and navigated to the iliac artery using imaging guidance.
4. Once at the target location, the occlusion device is deployed to block the blood flow in the desired section of the iliac artery.
5. The catheter is then removed, and the incision site is sealed.

Tools and equipment include catheters, imaging technology (like fluoroscopy), and the occlusion device itself.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

It is performed in a hospital setting, specifically in an interventional radiology suite or a specialized surgical center.

Personnel

• Interventional radiologist or vascular surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians

Risks and Complications

• Common risks: Bruising, bleeding at the insertion site
• Rare risks: Infection, allergic reaction to contrast dye, damage to blood vessels, thrombosis
• Possible complications: Device migration, re-bleeding, tissue ischemia

Benefits

• Effective in stopping blood flow to damaged artery sections
• Minimally invasive with quicker recovery time compared to open surgery
• Immediate reduction in risk of aneurysm rupture or hemorrhage

Recovery

• Patients might stay in the hospital for observation overnight.
• Post-procedure instructions include monitoring the incision site, keeping it clean and dry.
• Avoid strenuous activities for a few days.
• Follow-up appointments to assess the success of the procedure and device placement.

Alternatives

• Open surgical repair of the artery
• Conservative management with medication
• Other endovascular techniques, such as stent placement

Each alternative has its pros and cons, with open surgery being more invasive and having a longer recovery time, but potentially more thorough in certain cases.

Patient Experience

During the procedure, patients might feel pressure but not pain due to anesthesia. Afterward, some discomfort or soreness at the incision site is normal. Pain management includes prescribed medications and resting the affected area.