37243 Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction

Name of the Procedure:

Vascular Embolization or Occlusion

Summary

Vascular embolization or occlusion is a medical procedure used to block blood flow to specific areas of the body. This method is commonly utilized to treat tumors by cutting off their blood supply, induce organ ischemia, or manage infarction within organs. The procedure involves radiological imaging to precisely guide the intervention.

Purpose

This procedure is intended to manage medical conditions such as tumors, organ ischemia (reduced blood flow), or infarction (tissue death due to lack of blood supply). The primary goal is to stop or reduce blood flow to certain areas to either treat pathological conditions or protect healthy tissues.

Indications

• Tumors requiring decreased blood supply to inhibit growth.
• Organ ischemia to prevent further tissue damage.
• Infarctions that need controlled management.
• Persistent bleeding that needs to be stopped.

Patient criteria or factors making the procedure appropriate include:

• Diagnostic imaging confirming a condition treatable by occlusion.
• Patient health status supports the procedure without undue risk.

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Adjustments to medications, especially blood thinners, as directed by a doctor.
• Blood tests and imaging studies (like CT scans or MRIs) to plan the procedure.

Procedure Description

1. The patient is brought into the radiology suite.
2. Local anesthesia or sedation is administered to ensure comfort.
3. A small incision is made, often in the groin, to access a blood vessel.
4. A catheter is guided through the blood vessels to the targeted area using real-time imaging (intraprocedural roadmapping).
5. Embolic agents (tiny particles, coils, or liquids) are introduced through the catheter to block the blood vessel.
6. Final imaging confirms the occlusion is successful.
7. The catheter is removed, and the incision is closed.

Duration

The procedure typically takes 1 to 3 hours, depending on the complexity.

Setting

This procedure is performed in a hospital's radiology or interventional radiology suite.

Personnel

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

Risks and Complications

• Common: mild pain at the incision site, minor bruising, temporary nausea.
• Rare: infection, allergic reaction to embolic agents, unintended damage to nearby organs or tissues, blood clot formation.

Benefits

• Minimally invasive compared to surgical alternatives.
• Effectively reduces symptoms or progression of the underlying medical condition.
• Shorter recovery time compared to open surgery.

Recovery

• Patients typically stay in the hospital for 1-2 days.
• Post-procedure instructions include keeping the incision site clean and dry.
• Mild activity restrictions may be advisable for a few days.
• Follow-up appointments for imaging and to monitor recovery.

Alternatives

• Surgical resection of tumors or affected tissues.
• Medical management with drugs.
• Radiation therapy for certain types of tumors.

Pros and cons of these alternatives compared to vascular embolization or occlusion:

• Surgery: More invasive with longer recovery but may be more definitive.
• Medication: Less invasive but potentially less effective.
• Radiation: Non-invasive but has its own set of risks and side effects.

Patient Experience

During the procedure, patients are likely to feel some pressure but minimal pain due to sedation or anesthesia. Post-procedure, mild discomfort at the incision site is common, and pain management measures will be provided. Most patients return to normal activities within a week.