Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)
CPT4 code
Name of the Procedure:
Transcatheter permanent occlusion or embolization (e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord).
Summary
This procedure involves using a catheter to deliver material that blocks blood flow to a specific area of the central nervous system, such as the brain or spinal cord. It is minimally invasive and can be used to treat various conditions like tumors, bleeding, or abnormal blood vessels.
Purpose
The procedure is designed to cut off the blood supply to problematic areas, which can help shrink tumors, stop bleeding, or correct abnormal blood vessel formations within the brain or spinal cord.
Indications
- Tumors in the brain or spinal cord
- Intracranial or spinal hemorrhage
- Vascular malformations such as arteriovenous malformations (AVMs)
- Aneurysms that are at risk of rupturing
Preparation
- Patients may need to fast for a few hours before the procedure.
- Adjustments to current medications may be necessary.
- Pre-procedure imaging tests such as MRI or CT scans will be performed to map the area.
Procedure Description
- The patient is typically given local anesthesia and sedation or general anesthesia.
- A catheter is inserted into a blood vessel, usually in the groin, and guided to the targeted area in the central nervous system.
- Embolic agents (e.g., coils, particles) are delivered through the catheter to block blood flow.
- Imaging techniques such as fluoroscopy are used to ensure accurate placement.
Duration
The procedure typically takes 1-3 hours, depending on the complexity.
Setting
The procedure is performed in a hospital's interventional radiology suite or operating room.
Personnel
- Interventional radiologist or neuro-interventional specialist
- Anesthesiologist
- Nurses and radiology technicians
Risks and Complications
- Infection at the catheter insertion site
- Bleeding or bruising
- Blood clots (thrombosis)
- Vessel damage or rupture
- Stroke or transient ischemic attack (TIA)
- Post-procedure pain or discomfort
Benefits
- Minimally invasive alternative to open surgery
- Effective in reducing or eliminating the targeted problem
- Shorter recovery time compared to traditional surgery
- Immediate or gradual improvement in symptoms
Recovery
- Patients may need to stay in the hospital for observation for 1-2 days.
- Post-procedure instructions will include rest, avoiding heavy lifting, and monitoring the insertion site.
- Follow-up imaging tests will be scheduled to assess success.
- Full recovery typically takes a few days to a few weeks.
Alternatives
- Open surgical resection
- Radiation therapy (for tumors)
- Medical management for symptoms
- Each alternative comes with its own set of risks and benefits, with open surgery generally having longer recovery times and higher risk of complications.
Patient Experience
- Mild discomfort or pressure during catheter insertion.
- Post-procedure, patients may feel sore or experience mild pain at the catheter site.
- Pain management will be provided, including medications and comfort measures.
- Most patients can return to normal activities within a few days, with some restrictions on strenuous activities.