61626 Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; non-central nervous system, head or neck (extracranial, brachiocephalic branch)

Name of the Procedure:

Transcatheter Permanent Occlusion or Embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), Percutaneous, Any Method; Non-Central Nervous System, Head or Neck (Extracranial, Brachiocephalic Branch)

Summary

This minimally invasive procedure involves the use of a catheter to place materials that block blood flow to specific areas in the head or neck outside of the brain. This can be done to destroy tumors, stop bleeding, or close off abnormal blood vessels.

Purpose

• Medical Condition/Problem Addressed: The procedure treats issues such as tumors, uncontrolled bleeding (hemostasis), and vascular malformations in the head or neck that do not involve the brain.
• Goals/Expected Outcomes: The goal is to permanently block blood flow to the targeted area, which can help shrink tumors, stop bleeding, or correct abnormal blood vessel connections.

Indications

• Symptoms/Conditions Warranting the Procedure: Persistent bleeding, difficult-to-reach tumors, or vascular malformations.
• Patient Criteria: Patients with tumors in the head or neck, those experiencing problematic bleeding, or individuals with vascular anomalies.

Preparation

• Pre-procedure Instructions: Patients may be asked to fast for several hours before the procedure. Medication adjustments might be necessary, such as stopping blood thinners.
• Diagnostic Tests/Assessments: Imaging studies like CT scans, MRIs, or angiograms are typically done to map out the affected area.

Procedure Description

• Detailed Steps:
  1. An intravenous (IV) line is started for sedation or anesthesia.
  2. A small incision is made, usually in the groin, to insert the catheter into a blood vessel.
  3. Using imaging guidance, the catheter is navigated to the target blood vessel in the head or neck.
  4. Embolic materials (such as coils, particles, or glue) are released through the catheter to block the blood flow.
  5. The catheter is then withdrawn, and pressure is applied to the incision site to prevent bleeding.
• Tools and Technology Used: Catheters, embolic materials (coils, particles, glue), imaging equipment (fluoroscopy, CT).
• Anesthesia/Sedation: Local anesthetic at the incision site; sedation or general anesthesia may be used depending on the case.

Duration

The procedure generally takes between 1 to 3 hours, depending on complexity and specifics of the case.

Setting

Typically performed in a hospital's interventional radiology or surgical suite.

Personnel

• Interventional radiologist or vascular surgeon
• Nurses
• Radiologic technologist
• Anesthesiologist, if general anesthesia is used

Risks and Complications

• Common Risks: Bruising at the incision site, mild pain or discomfort, bleeding.
• Rare Risks: Infection, allergic reaction to the dye used for imaging, unintended blockage of non-target vessels, damage to blood vessels, stroke.
• Complication Management: Close monitoring, medications, additional interventions if needed.

Benefits

• Expected Outcomes: Reduction in the size of tumors, cessation of bleeding, correction of vascular malformations.
• Realization Time: Benefits may be seen immediately for bleeding control; tumor shrinkage or vascular correction can take weeks to months.

Recovery

• Post-procedure Care and Instructions: Bed rest for several hours, monitoring of vital signs, hydration, and light activities initially.
• Expected Recovery Time: Most patients can return to normal activities within a week. Follow-up appointments will be necessary to monitor progress.
• Restrictions: Avoid heavy lifting and strenuous activities for a few days.

Alternatives

• Other Treatment Options: Surgery, radiation therapy, medical therapy (medications for bleeding control).
• Pros and Cons: Surgery is more invasive and involves a longer recovery time. Radiation therapy may not be suitable for all tumor types or vascular issues. Medication may only provide temporary relief.

Patient Experience

• During the Procedure: Patients may feel pressure but should experience minimal pain due to sedation or anesthesia.
• After the Procedure: Some discomfort or pain at the incision site, managed with pain medications. Overall feeling of tiredness which improves over a few days.
• Pain Management and Comfort: Pain relief medications as needed, and supportive care from the healthcare team.