Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (List separately in add
CPT4 code
Name of the Procedure:
Transluminal Balloon Angioplasty (Including All Necessary Imaging and Radiological Supervision and Interpretation Within the Same Vein; Each Additional Vein)
Summary
Transluminal balloon angioplasty is a medical procedure used to open up blocked or narrowed veins. This involves inserting a small balloon through the skin or via an open surgery into the affected vein, then inflating it to widen the vein and improve blood flow, along with necessary imaging for guidance.
Purpose
Medical Condition or Problem:
The procedure addresses vein blockages, poor blood flow, or venous stenosis, which can cause pain, swelling, and other complications.
Goals:
The primary goal is to restore proper blood flow through the affected vein, alleviate symptoms, and prevent further complications.
Indications
Specific Symptoms or Conditions:
- Chronic venous insufficiency
- Swollen limbs due to vein blockages
- Pain or discomfort from narrowed veins
- Ulcers or sores not healing due to insufficient blood flow
Patient Criteria:
- Patients with confirmed venous blockages or narrowings
- Non-responsive to other conservative treatments
- Suitable anatomy for the procedure based on imaging studies
Preparation
Pre-procedure Instructions:
- Fasting for several hours before the procedure
- Adjustments in medications, especially blood thinners ##### Diagnostic Tests:
- Blood tests
- Imaging studies like ultrasound, CT scan, or MRI to map the veins
Procedure Description
Step-by-Step Explanation:
- Initialization: Patient sedation/anesthesia as required.
- Access Point: A small incision made at the access point.
- Guide Wire Insertion: A thin wire is navigated into the blocked vein.
- Balloon Catheter Placement: A balloon-tipped catheter is threaded over the wire to the blockage site.
- Balloon Inflation: The balloon is inflated to widen the vein.
- Stent Placement (if needed): A stent may be placed to keep the vein open.
- Deflation & Removal: The balloon is deflated and removed.
Tools and Equipment:
- Guide wire
- Balloon catheter
- Imaging equipment (fluoroscopy, ultrasound)
- Possible stenting tools
Anesthesia or Sedation:
- Local anesthesia at the puncture site
- Sedation or general anesthesia based on patient health and procedure complexity
Duration
The procedure typically takes between 1 to 2 hours.
Setting
Performed in a hospital’s interventional radiology suite or an operating room.
Personnel
- Interventional radiologist or vascular surgeon
- Nurses
- Anesthesiologist
Risks and Complications
Common Risks:
- Slight bleeding or bruising at the puncture site
- Mild to moderate pain or discomfort
Rare Risks:
- Infection
- Vessel damage
- Blood clots
- Allergic reactions to contrast dye
Management:
Most complications are managed with medications, compressive measures, or further interventions if needed.
Benefits
Expected benefits include improved blood flow, reduced symptoms like pain and swelling, and prevention of complications related to venous blockages. Benefits are usually seen soon after the procedure and continue to improve over time.
Recovery
Post-procedure Care:
- Rest for a few hours to a day
- Gradual return to normal activities based on physician advice ##### Expected Recovery Time:
- Full recovery within a week
- Follow-up appointments to monitor vein status
Alternatives
Other Treatment Options:
- Conservative management with compression stockings
- Medication to improve blood flow
- Surgical vein bypass
Pros and Cons:
- Angioplasty provides faster relief and is less invasive than bypass surgery but carries its specific risks.
- Conservative treatments are less invasive but may not be effective for severe blockages.
Patient Experience
During the Procedure:
- Minimal pain due to local anesthesia
- Mild discomfort during balloon inflation
After the Procedure:
- Some soreness at access site
- Pain management with prescribed analgesics
- Gradual improvement in symptoms like swelling and pain
Patient comfort measures are taken seriously, including prompt pain management and clear communication throughout the procedure steps.