36100 Introduction of needle or intracatheter, carotid or vertebral artery

Name of the Procedure:

Introduction of Needle or Intracatheter, Carotid or Vertebral Artery

• Common Names: Carotid Artery Needle Insertion, Vertebral Artery Needle Insertion, Intracatheterization.
• Medical Terms: Carotid Artery Puncture, Vertebral Artery Cannulation.

Summary

This procedure involves inserting a needle or catheter into either the carotid or vertebral artery. It is often a preliminary step for treatments or diagnostic studies involving blood vessels in the neck and brain.

Purpose

Medical Condition:

This procedure is used to diagnose or treat conditions related to blood flow in the carotid or vertebral arteries, such as artery blockages or aneurysms.

Goals:

• To visualize blood flow and detect abnormalities using imaging.
• To deliver medications directly into an artery.
• To assist in further interventional procedures.

Indications

• Symptoms like transient ischemic attacks (TIA) or strokes.
• Severe headaches or neck pain suggestive of vascular issues.
• Abnormal results from non-invasive tests (e.g., ultrasound).

Preparation

• Patients may be asked to fast for 6-8 hours before the procedure.
• Medication adjustments might be needed, especially for blood thinners.
• Pre-procedure assessments can include blood tests, and imaging studies like CT or MRI scans.

Procedure Description

• Step 1: Patient is positioned, typically lying on their back or slightly inclined.
• Step 2: Local anesthesia is applied to the insertion site.
• Step 3: A needle is carefully inserted into the targeted artery using ultrasound or fluoroscopic guidance.
• Step 4: Once the needle is in place, an intracatheter may be introduced for extended procedures.
• Tools/Equipment: Needles, intracatheters, ultrasound machine, fluoroscope.
• Anesthesia: Usually local anesthesia; general anesthesia is rare.

Duration

The procedure typically lasts between 30 minutes to 1 hour, depending on complexity.

Setting

The procedure is performed in a hospital or specialized outpatient surgical center with imaging capabilities.

Personnel

• Interventional Radiologist or Vascular Surgeon.
• Assisting Nurses.
• Anesthesiologist (if sedation or anesthesia is required).

Risks and Complications

• Common Risks: Bruising, minor bleeding at the puncture site.
• Rare Complications: Arterial damage, infection, stroke, hematoma formation.
• Management: Immediate intervention for any serious complications.

Benefits

• Provides critical information on artery health.
• Enables targeted treatment delivery, potentially alleviating symptoms quickly.

Recovery

• Patients may be monitored for several hours post-procedure.
• Instructions may include avoiding strenuous activities and monitoring the puncture site for signs of infection.
• Recovery time varies, but most patients can return to normal activities within 24-48 hours.
• Follow-up appointments are often scheduled to evaluate the outcome and plan further treatment if needed.

Alternatives

• Non-invasive imaging techniques like Doppler ultrasound or MRI angiography.
• Pros: Non-invasive, no recovery time.
• Cons: Less precise in some cases, may not allow for immediate treatment.

Patient Experience

• Patients might feel pressure or mild discomfort during needle insertion.
• Most report minimal pain due to local anesthesia.
• Post-procedure, mild soreness at the puncture site can be managed with over-the-counter pain relievers and is generally short-lived.