Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Transluminal balloon angioplasty, venous
Common name(s): Balloon angioplasty, Venous angioplasty
Technical/medical term: Percutaneous transluminal angioplasty of venous structures, Subclavian stenosis angioplasty
Summary
Balloon angioplasty is a minimally invasive procedure used to open up narrowed or blocked veins, especially in areas like the subclavian vein. It involves inserting a small balloon-tipped catheter into the affected vein and inflating it to widen the passage.
Purpose
Balloon angioplasty addresses venous stenosis or narrowing, which can restrict blood flow and cause discomfort or swelling. The goal is to restore normal blood flow and relieve symptoms by widening the narrowed vein.
Indications
- Chronic venous insufficiency or swelling in the arms
- Symptoms like pain, swelling, or heaviness due to vein narrowing
- Conditions like Paget-Schroetter syndrome
Preparation
- Fasting for a few hours before the procedure
- Adjusting medications as advised, especially blood thinners
- Pre-procedure imaging tests like ultrasound or venography
Procedure Description
- Local anesthesia or sedation is administered.
- A small incision is made, usually in the groin area.
- A catheter is guided through the venous system to the site of the stenosis.
- A balloon on the catheter's tip is inflated, expanding the vein.
- After sufficient dilation, the balloon is deflated and removed.
- Imaging techniques like fluoroscopy are used throughout the procedure for guidance.
- Sometimes a stent may be placed to keep the vein open.
Duration
Typically takes about 1 to 2 hours.
Setting
Performed in a hospital's radiology or interventional cardiology suite.
Personnel
- Interventional radiologist or vascular surgeon
- Radiologic technologists
- Anesthesiologist or nurse anesthetist
- Nursing staff
Risks and Complications
- Bleeding or bruising at the insertion site
- Infection
- Blood clots
- Vessel damage or rupture
- Allergic reaction to contrast dye
- Rarely, need for additional surgical intervention
Benefits
- Improved blood flow
- Relief from symptoms like swelling and pain
- Enhanced quality of life Benefits are typically realized immediately or within a few days post-procedure.
Recovery
- Monitoring in a recovery area for a few hours post-procedure
- Instructions on keeping the insertion site clean and dry
- Restricted activities for a few days
- Follow-up imaging or consultations
Alternatives
- Conservative treatment with medications and compression garments
- Open surgical repair
- Use of stents alone without balloon angioplasty
- Pros and cons depend on the extent of vein narrowing and patient's overall health
Patient Experience
- During the procedure: Mild discomfort or pressure, managed with local anesthesia and sedation
- After the procedure: Some soreness at the insertion site, managed with pain relievers
- Regular follow-ups and imaging to monitor vein status