35458 Transluminal balloon angioplasty, open; brachiocephalic trunk or branches, each vessel

Name of the Procedure:

Transluminal Balloon Angioplasty, Open; Brachiocephalic Trunk or Branches, Each Vessel Common Names: Balloon Angioplasty, Angioplasty for Brachiocephalic Arteries

Summary

Transluminal balloon angioplasty is a minimally invasive medical procedure used to open up narrowed or blocked arteries in the brachiocephalic trunk or its branches using a small balloon. The balloon is inflated to widen the artery, restore blood flow, and alleviate symptoms associated with arterial blockage.

Purpose

This procedure is performed to address narrowing (stenosis) or blockages in the arteries supplying blood to the brain, neck, and arms. The primary goals are to improve blood flow, reduce the risk of stroke, and alleviate symptoms such as dizziness, fainting, and arm pain.

Indications

• Symptoms of arterial stenosis, such as dizziness, confusion, or fainting
• Arm pain or weakness due to poor blood flow
• History of stroke or transient ischemic attack (TIA)
• Diagnostic imaging showing significant artery narrowing or blockage

Preparation

• Patients may be required to fast for several hours before the procedure.
• Blood tests, imaging studies, and possibly an electrocardiogram (ECG) will be conducted.
• Medications, especially blood thinners, may need to be adjusted before the procedure.
• Consent forms will be signed after discussing the procedure, risks, and benefits with the patient.

Procedure Description

1. The patient is placed under sedation or general anesthesia.
2. The surgeon makes a small incision near the affected artery.
3. A catheter with a deflated balloon on its tip is inserted into the artery.
4. The catheter is guided to the narrowed or blocked section of the artery using imaging technology.
5. Once in position, the balloon is inflated to compress the plaque against the artery walls, widening the vessel.
6. The balloon is then deflated and removed along with the catheter.
7. The incision is closed with sutures or adhesives.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

Performed in a hospital operating room or specialized surgical center with imaging facilities.

Personnel

• Vascular surgeon or interventional radiologist
• Anesthesiologist
• Surgical nurses and technicians
• Radiologic technologist (for imaging)

Risks and Complications

• Infection at the site of incision
• Bleeding or hematoma formation
• Arterial rupture or damage
• restenosis (re-narrowing of the artery)
• Blood clots that could lead to stroke
• Reaction to anesthesia

Benefits

• Increased blood flow to the brain, neck, and arms
• Reduced symptoms like dizziness, pain, and weakness
• Decreased risk of stroke
• Immediate improvement in blood circulation post-procedure

Recovery

• Patients may need to stay in the hospital for 1-2 days for observation.
• Avoid strenuous activities and heavy lifting for a few weeks.
• Follow-up appointments will monitor the artery's condition and overall recovery.
• Medications may be prescribed to prevent blood clots and manage pain.

Alternatives

• Medication management to control symptoms and prevent worsening
• Lifestyle changes like diet and exercise
• Open surgical repair (endarterectomy)
• Stenting (inserting a small mesh tube to keep the artery open)

Patient Experience

Patients are usually under anesthesia during the procedure, so they feel no pain. Post-procedure, they might experience some soreness at the incision site and temporary fatigue. Pain management and comfort measures will be provided to ensure a smooth recovery.