37247 Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to p

Name of the Procedure:

Transluminal Balloon Angioplasty (excluding lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit)

• Common Names: Balloon Angioplasty, Percutaneous Transluminal Angioplasty (PTA)

Summary

Transluminal balloon angioplasty is a minimally invasive procedure designed to open up narrowed or blocked blood vessels. This is achieved by threading a thin catheter with a small balloon at its tip to the site of the blockage and inflating the balloon to widen the vessel.

Purpose

The procedure addresses blocked or narrowed blood vessels, which impede normal blood flow. The goals are to restore proper blood circulation, relieve symptoms like pain or discomfort, and prevent more severe complications such as tissue damage or organ failure.

Indications

• Symptoms of reduced blood flow such as pain, numbness, or decreased function in affected areas.
• Conditions like arteriosclerosis or other vascular diseases causing the narrowing of arteries.
• Patients who have not responded to other medical treatments or are not candidates for more invasive surgical methods.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Blood tests, imaging studies (like an ultrasound or angiogram), and a thorough medical history and physical examination are typically required.
• Patients may need to adjust or stop certain medications, especially blood thinners.

Procedure Description

1. Insertion: A small incision is made, typically in the groin or arm. Through this, a catheter is inserted into the blood vessel.
2. Navigation: Using imaging guidance, the catheter is maneuvered to the site of the blockage.
3. Balloon Inflation: Once in place, the balloon on the tip of the catheter is inflated to stretch and widen the narrowed vessel.
4. Deflation and Removal: After the vessel is widened, the balloon is deflated and the catheter is carefully removed.
5. Imaging: All steps are monitored and guided via real-time imaging techniques like fluoroscopy or ultrasound.

Duration

The procedure typically takes 1-3 hours, depending on the complexity and location of the narrowed vessel.

Setting

Transluminal balloon angioplasty is usually performed in a hospital's catheterization lab or an outpatient surgical center equipped with advanced imaging equipment.

Personnel

• Interventional Radiologist or Vascular Surgeon
• Nurses
• Radiologic Technologist
• Anesthesiologist or Nurse Anesthetist (if sedation or anesthesia is required)

Risks and Complications

• Common: Bruising or bleeding at the catheter insertion site.
• Rare: Blood vessel damage, infection, blood clots, allergic reaction to contrast dye, or restenosis (re-narrowing of the vessel).

Benefits

• Improved blood flow and relief from symptoms like pain and numbness.
• Minimally invasive with shorter recovery time compared to open surgery.
• Immediate improvement often observed, with further benefits as healing progresses.

Recovery

• Patients may need to stay in the hospital for observation for a few hours or overnight.
• Instructions on wound care, activity restrictions, and medication adjustments will be provided.
• Follow-up appointments are necessary to monitor the success of the procedure and vessel patency.
• Most patients can resume normal activities within a week, but heavy lifting or strenuous exercise should be avoided for a short period.

Alternatives

• Medications to manage symptoms and improve blood flow.
• Lifestyle changes such as diet and exercise modifications.
• Surgical options like bypass surgery, which is more invasive but might be needed for complex cases.

Patient Experience

Patients may feel pressure but should not experience significant pain during the procedure due to local anesthesia and possibly mild sedation. Mild discomfort at the catheter insertion site is common afterwards, but pain can usually be managed with over-the-counter pain relievers. Regular follow-up is crucial to ensure the long-term success of the procedure and monitor for any complications.