Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)
CPT4 code
Name of the Procedure:
Selective Catheter Placement, Venous System; First Order Branch (e.g., Renal Vein, Jugular Vein)
Summary
Selective catheter placement in the venous system involves threading a thin tube (catheter) into a specific vein, such as the renal or jugular vein, to diagnose or treat various conditions.
Purpose
This procedure helps diagnose problems or deliver treatments directly to a specific area in the venous system. Goals include obtaining blood samples, delivering medications, or performing angiograms to visualize blood flow.
Indications
- Unexplained swelling or edema
- Suspicion of vein blockage or narrowing
- Need for intravenous medication directly in the vein
- Assessment of vein function and structure
Preparation
- Fasting for 6-8 hours before the procedure
- Adjusting or stopping certain medications as instructed
- Blood tests or imaging studies like an ultrasound or MRI
Procedure Description
- Initial Setup:
- An IV line is inserted for medications.
- Area of catheter insertion cleaned and numbed.
- Insertion:
- A small incision is made to access the vein.
- The catheter is carefully threaded through the vein to the target location (e.g., renal or jugular vein).
- Positioning:
- Real-time imaging (fluoroscopy) guides the catheter placement.
- Diagnosis/Treatment:
- Possible actions include drawing blood samples, injecting contrast dye for imaging, or delivering medications.
- Completion:
- The catheter is removed, the incision site is closed, and dressed.
Tools: Fluoroscopy, local anesthetics, catheters.
Duration
Approximately 1-2 hours.
Setting
Typically performed in a hospital's radiology department or an outpatient clinic with imaging facilities.
Personnel
- Interventional radiologist or specialized physician
- Radiology technologist
- Nursing staff
- Anesthesiologist (if sedation is needed)
Risks and Complications
- Infection at the catheter insertion site
- Blood vessel damage
- Blood clot formation
- Allergic reaction to contrast dye
- Bleeding or bruising
Benefits
- Accurate diagnosis of venous conditions
- Effective delivery of targeted treatments
- Minimal recovery time
- Low risk and minimally invasive
Recovery
- Monitoring for a few hours post-procedure
- Keeping the insertion site clean and dry
- Avoiding strenuous activities for 24-48 hours
- Follow-up appointments for further assessment
Alternatives
- Non-invasive imaging techniques (e.g., MRI, CT scan)
- Systemic medication delivery
- Surgical exploration if necessary
- Pros: Non-invasive options may have fewer risks.
- Cons: Less precise and potentially less effective treatment delivery.
Patient Experience
- Minimal discomfort with local anesthesia
- Feeling of pressure during the catheter insertion
- Potential mild soreness at insertion site post-procedure
- Pain management with over-the-counter pain relievers as prescribed.