36014 Selective catheter placement, left or right pulmonary artery

Name of the Procedure:

Selective catheter placement, left or right pulmonary artery

Summary

In selective catheter placement, a thin, flexible tube (catheter) is inserted into the left or right pulmonary artery. This is done to get detailed images of the lung's blood vessels or to perform specific treatments directly in the lungs.

Purpose

Selective catheter placement in the pulmonary artery is used to:

• Diagnose lung conditions such as pulmonary embolism, or blockages.
• Measure the pressure in the pulmonary arteries.
• Deliver medication or other treatments directly to the lungs.

Indications

• Suspected pulmonary embolism
• Pulmonary hypertension
• Congenital heart disease affecting the lungs
• Chronic thromboembolic disease
• Unexplained shortness of breath

Preparation

• Fasting for 6-8 hours before the procedure.
• Adjustments to medications, especially blood thinners.
• Pre-procedure tests may include blood work, EKG, and chest X-ray.

Procedure Description

1. The patient is positioned on the examination table, typically lying flat on their back.
2. A local anesthetic is administered at the insertion site, usually in the groin or arm.
3. A tiny incision is made, and a catheter is inserted into a blood vessel.
4. Using imaging guidance (fluoroscopy), the catheter is navigated through the blood vessels to the pulmonary artery.
5. Contrast dye may be injected to enhance imaging of the arteries.
6. Data is collected, and any necessary treatments are administered.
7. The catheter is carefully removed, and the incision site is closed and bandaged.

Duration

The procedure typically takes about 1-2 hours, but this can vary depending on the complexity.

Setting

It is usually performed in a hospital or specialized outpatient clinic with a catheterization laboratory.

Personnel

• Interventional radiologist or cardiologist
• Nursing staff
• Radiology technician
• Anesthesiologist (if sedation is used)

Risks and Complications

Common risks:

• Bruising or bleeding at the insertion site
• Allergic reaction to contrast dye
• Infection Rare risks:
• Damage to blood vessels
• Dislodgement of blood clots
• Arrhythmias

Benefits

• Accurate diagnosis and tailored treatment of lung conditions.
• Symptom relief and improved lung function, often noticeable within days.

Recovery

• Patients are monitored for several hours post-procedure.
• Instructions to avoid strenuous activities for a few days.
• If sedated, someone should drive the patient home.
• Follow-up appointments to monitor recovery and effectiveness of treatment.

Alternatives

• Non-invasive imaging tests like CT or MRI scans.
• Medications alone to address certain conditions.
• Surgical interventions for more severe or unresponsive cases.

Patient Experience

• Mild discomfort or pressure at the insertion site.
• Possible sensation of warmth when contrast dye is injected.
• Pain management provided as needed.
• Post-procedure soreness and recommendations for comfort, like ice packs and rest.