37241 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous ma

Name of the Procedure:

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (e.g., congenital or acquired venous malformations)

Summary

Vascular embolization or occlusion is a minimally invasive procedure where a radiologist uses imaging guidance to insert materials into a vein to block blood flow. This technique treats various conditions related to abnormal or problematic veins, such as congenital or acquired venous malformations.

Purpose

This procedure is performed to:

• Address venous malformations that cause pain, swelling, or other symptoms.
• Prevent complications from abnormal veins.
• Improve the quality of life by reducing symptoms related to vein issues.

Indications

• Congenital or acquired venous malformations
• Symptoms like pain, swelling, or functional impairment due to problematic veins
• Cases where other treatments have failed or are not suitable

Preparation

• Fasting for a few hours before the procedure
• Adjusting current medications as directed by the healthcare provider
• Conducting diagnostic tests such as ultrasound or MRI to identify the affected veins

Procedure Description

1. The patient receives local anesthesia or sedation.
2. A small incision is made to access the vein.
3. A catheter is inserted and guided through the vein using imaging techniques.
4. Embolic material (such as coils, foam, or glue) is delivered through the catheter to block the vein.
5. Imaging guidance (e.g., X-ray, fluoroscopy) confirms the correct placement of the embolic material.
6. The catheter is removed, and the incision is closed.

Tools and equipment:

• Catheters, embolic agents, imaging systems like X-ray or fluoroscopy

Duration

Typically, the procedure takes about 1 to 3 hours.

Setting

Performed in a hospital's interventional radiology suite or an outpatient surgical center.

Personnel

• Interventional radiologist
• Radiology technologists
• Nurses
• Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

• Infection at the incision site
• Bleeding or bruising
• Allergic reaction to contrast dye
• Migration of embolic material to unintended sites
• Pain or discomfort
• Rarely, damage to the vein or surrounding tissues

Benefits

• Reduction or elimination of symptoms caused by venous malformations
• Minimally invasive with quicker recovery compared to open surgery
• Immediate improvement in some cases, with full benefits typically seen within a few weeks

Recovery

• Observation for a few hours after the procedure
• Instructions to keep the insertion site clean and dry
• Avoid heavy lifting or strenuous activities for a few days
• Follow-up appointments to monitor the effectiveness of the treatment

Alternatives

• Surgical removal of the problematic vein (vein stripping)
• Sclerotherapy (injecting a solution to collapse the vein)
• Compression therapy
• The choice of alternative depends on the specific condition, patient's health, and preference

Patient Experience

• The patient may feel slight pressure during insertion of the catheter.
• Post-procedure discomfort can be managed with over-the-counter pain medication.
• Brave mild soreness at the insertion site for a few days.
• Encouragement to stay hydrated and avoid strenuous activities during recovery.