Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein
CPT4 code
Name of the Procedure:
Insertion of Cannula for Hemodialysis, Other Purpose (Separate Procedure); Vein to Vein
Summary
This procedure involves placing a cannula (a thin tube) into a vein to prepare for hemodialysis. Hemodialysis is a treatment that filters waste and water from the blood, functioning as an artificial kidney for patients with renal failure.
Purpose
This procedure is used to create an access point for hemodialysis treatment, allowing long-term dialysis management for patients with chronic kidney disease or acute renal failure. Its goal is to facilitate efficient and regular removal of blood waste products, which the kidneys are no longer able to filter.
Indications
- Chronic kidney disease (CKD)
- Acute renal failure requiring dialysis
- Certain metabolic conditions needing temporary hemodialysis
- Preparation for ongoing kidney treatment and possible transplant
Preparation
- Patients may need to fast for several hours before the procedure.
- Blood tests and imaging studies (e.g., ultrasound, X-ray) might be required to find the best vein.
- Pre-procedure medications may be adjusted, and blood-clotting tests performed.
Procedure Description
- Anesthesia: Local anesthesia is applied to numb the insertion area.
- Sterilization: The site is cleaned and sterilized.
- Insertion: A small incision is made, and the cannula is inserted into a selected vein, often in the upper arm.
- Positioning: The cannula is carefully positioned with the aid of ultrasound or fluoroscope for precise placement.
- Securing: The cannula is secured in place, and connections are made for future dialysis sessions.
Tools/Equipment: Cannula, ultrasound machine, sterile drapes, and local anesthetic.
Duration
The procedure generally takes about 30 to 60 minutes.
Setting
This procedure is performed in a hospital, outpatient clinic, or surgical center.
Personnel
- Nephrologist or Vascular Surgeon
- Nurse
- Ultrasound Technician (if imaging is used)
- Anesthesiologist or Nurse Anesthetist (if needed)
Risks and Complications
- Infection at the insertion site
- Bleeding or hematoma
- Vein damage or thrombosis
- Displacement or malfunction of the cannula
- Rarely, air embolism
Benefits
- Ensures effective dialysis sessions
- Minimizes discomfort from repeated needle insertions
- Long-term access for ongoing dialysis treatments
- Immediate function post-insertion
Recovery
- Post-procedure monitoring for a few hours to ensure stability
- Instructions on keeping the site clean and dry
- Restrictions on lifting heavy objects or strenuous activity for a few days
- Regular follow-up appointments to check the cannula’s condition and function
Alternatives
- Peritoneal dialysis: Another form of dialysis where a fluid is used to absorb waste from the blood through the abdominal lining.
- Different vascular access types: AV Fistula or AV Graft as more permanent solutions.
- Medication management and dietary changes for less severe cases.
Patient Experience
Patients might feel slight pressure during the insertion and some soreness afterward. Pain management includes local anesthesia during the procedure and over-the-counter pain relief meds post-procedure. Comfort measures include using a soft covering over the cannula site and avoiding tight clothing.
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