36015 Selective catheter placement, segmental or subsegmental pulmonary artery

Name of the Procedure:

Selective catheter placement, segmental or subsegmental pulmonary artery.

Summary

Selective catheter placement in the segmental or subsegmental pulmonary artery is a medical procedure where a thin, flexible tube (catheter) is inserted through a blood vessel and guided into a specific region of the lung's blood vessels. This allows for precise diagnostic imaging, delivery of medications, or other medical interventions directly to the targeted area.

Purpose

This procedure is primarily used to diagnose or treat pulmonary conditions such as pulmonary embolism, abnormal blood flow, or localized pulmonary hypertension. The goal is to obtain detailed information or deliver treatment precisely where it is needed, improving the outcomes and reducing side effects.

Indications

• Symptoms of pulmonary embolism or blood clots in the lungs
• Unexplained shortness of breath with suspected pulmonary vascular cause
• Assessment of pulmonary hypertension
• Evaluation of abnormal blood vessel structure or function in the lungs

Preparation

• Fasting for 6-8 hours prior to the procedure
• Adjustments to current medications, as advised by the physician
• Pre-procedure imaging studies or blood tests as needed
• Avoidance of certain medications that could increase bleeding risk

Procedure Description

1. The patient is placed on an examination table, and an intravenous (IV) line is started.
2. A local anesthetic is administered to numb the entry site, usually in the groin or arm.
3. A small incision is made, and a catheter is inserted into a major blood vessel.
4. Using X-ray guidance, the catheter is carefully maneuvered into the segmental or subsegmental pulmonary artery.
5. Diagnostic imaging is performed or medications are administered as required.
6. Upon completion, the catheter is removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes 1 to 2 hours.

Setting

It is usually performed in a hospital's radiology or interventional cardiology department.

Personnel

• Interventional radiologist or cardiologist
• Radiologic technologists
• Nurses
• Anesthesiologist or sedation nurse, if necessary

Risks and Complications

• Bleeding or hematoma at the insertion site
• Infection
• Allergic reactions to contrast dye
• Blood vessel damage
• Rare risk of causing a small blood clot or dislodgement leading to pulmonary embolism

Benefits

• Accurate diagnosis and targeted treatment of pulmonary issues
• Minimally invasive with quick recovery time
• Reduces the need for more extensive surgical procedures
• Can provide immediate symptom relief in certain conditions

Recovery

• Patients may need to lie flat for a few hours post-procedure to ensure the insertion site heals properly.
• Home rest is typically recommended for the rest of the day.
• Avoid strenuous activities for the next 24-48 hours.
• Follow-up appointments will be scheduled to monitor recovery and treatment efficacy.

Alternatives

• Non-invasive imaging tests like CT or MRI scans
• Systemic medication treatments for pulmonary conditions
• Surgical intervention, in cases where catheter-based methods are not suitable

Patient Experience

During the procedure, patients are usually awake but sedated. They may feel pressure or slight discomfort at the insertion site. Pain management is provided as needed. Post-procedure, there may be mild soreness at the entry site, which typically resolves within a few days.