Transluminal balloon angioplasty, each additional visceral artery, radiological supervision and interpretation (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Transluminal Balloon Angioplasty, Each Additional Visceral Artery, Radiological Supervision and Interpretation
Summary
Transluminal balloon angioplasty is a minimally invasive procedure used to widen narrowed or blocked arteries in the abdomen. The "each additional visceral artery" part means this code is used when more than one artery is treated, and this happens under radiological guidance.
Purpose
Medical Condition or Problem Addressed:
The procedure primarily treats conditions where visceral arteries (arteries supplying blood to organs like the intestines, liver, and spleen) are narrowed or blocked, often due to atherosclerosis.
Goals or Expected Outcomes:
- Restoring adequate blood flow to affected abdominal organs
- Relieving symptoms such as abdominal pain
- Preventing complications such as organ damage
Indications
Specific Symptoms or Conditions:
- Chronic abdominal pain, especially after eating (indicative of mesenteric ischemia)
- Unexplained weight loss
- Evidence of visceral artery stenosis or blockage on imaging tests
Patient Criteria:
- Patients diagnosed with significant visceral artery narrowing
- Those who have not responded to medical therapy or lifestyle modifications
Preparation
Pre-procedure Instructions:
- Fasting for 6-8 hours before the procedure
- Adjusting or stopping certain medications (such as blood thinners) as advised by the doctor
- Undergoing pre-procedure imaging tests (like CT or MRI angiography)
Procedure Description
A step-by-step explanation:
- Anesthesia/Sedation: Typically performed under local anesthesia with mild sedation.
- Access: A small incision is made in the groin to access the femoral artery.
- Navigation: Using fluoroscopic (X-ray) guidance, a catheter with a deflated balloon at its tip is threaded through the blood vessels to the site of the blockage in the visceral artery.
- Balloon Inflation: The balloon is inflated at the narrowed area, which compresses the plaque against the artery walls and opens up the artery.
- Imaging: Continuous radiological imaging is used to monitor the position of the catheter and the balloon.
- Completion: After sufficient widening, the balloon is deflated and removed, and sometimes a stent is placed to keep the artery open.
Tools and Equipment:
- Catheter with a balloon
- X-ray fluoroscopy machine
- Contrast dye for imaging
Duration
Typically takes 1 to 2 hours.
Setting
Usually performed in a hospital’s radiology or interventional radiology suite.
Personnel
- Interventional radiologist or vascular surgeon
- Radiology technician
- Nurse
- Anesthesiologist or sedation nurse
Risks and Complications
Common Risks:
- Bleeding or bruising at the insertion site
- Allergic reaction to contrast dye
Rare Risks:
- Vessel injury or rupture
- Kidney damage from contrast dye
- Infection at the incision site
Complication Management:
Immediate medical intervention and, if necessary, surgical repair.
Benefits
- Improved blood flow to abdominal organs
- Relief from symptoms like abdominal pain
- Rapid recovery time compared to open surgery
Recovery
Post-procedure Care:
- Monitoring in the hospital for several hours
- Instructions on limiting physical activity for a few days
- Keeping the incision site clean and dry
Expected Recovery Time:
Most patients can return to normal activities within a week, with follow-up appointments scheduled to monitor progress.
Alternatives
Other Treatment Options:
- Medical management with medications
- Open surgical bypass
- Lifestyle modifications
Pros and Cons of Alternatives:
- Medication: Less invasive but may not be effective for severe blockages
- Surgery: More invasive with longer recovery but potentially longer-lasting results
Patient Experience
During the Procedure:
- Mild discomfort or pressure at the incision site
- Sensation of balloon inflation (usually not painful)
After the Procedure:
- Mild soreness at the incision site
- Possible fatigue
- Pain management with over-the-counter pain relievers
Comfort measures include ensuring proper sedation and local anesthesia during the procedure and applying ice packs to the incision site post-procedure.
This markdown text provides a comprehensive yet digestible overview of the procedure, suitable for a patient education brochure or online resource.