Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Change of Percutaneous Tube or Drainage Catheter with Contrast Monitoring, Radiological Supervision, and Interpretation
Summary
This procedure involves replacing an existing percutaneous tube or drainage catheter with the aid of contrast monitoring under radiological supervision to ensure accurate placement. It is commonly used in the genitourinary system or for managing abscesses.
Purpose
The procedure is designed to address issues related to malpositioned, blocked, or malfunctioning percutaneous tubes or drainage catheters. The goals include restoring proper drainage, preventing infection, and improving the patient's comfort and health outcomes.
Indications
- Blockage or malfunction of an existing drainage catheter.
- Infection or leakage at the catheter site.
- Conditions requiring ongoing drainage, such as abscesses or fluid collections in the genitourinary system.
- Patients who have previously placed catheters needing periodic replacement.
Preparation
- Patients may be required to fast for several hours before the procedure.
- Adjustments to certain medications, particularly blood thinners, may be necessary.
- Pre-procedure imaging studies or diagnostic tests, such as ultrasound or CT scans, may be conducted.
Procedure Description
- The patient is positioned appropriately and local anesthesia is administered to numb the insertion site.
- The existing tube or catheter is carefully removed.
- Contrast dye is injected to visualize the area under fluoroscopy, ensuring accurate placement.
- A new catheter is introduced and guided into position using radiological imaging.
- Correct placement is confirmed, and the catheter is secured in place.
- Dressings are applied to the insertion site.
Advanced imaging technology and percutaneous access tools are used. The procedure typically involves local anesthesia and mild sedation to ensure patient comfort.
Duration
The procedure usually takes between 30 to 60 minutes.
Setting
The procedure is performed in a hospital interventional radiology suite or an outpatient clinic equipped with radiological facilities.
Personnel
- Interventional Radiologist
- Radiologic Technologist
- Registered Nurse
- Anesthesiologist (if sedation is required)
Risks and Complications
- Infection at the insertion site
- Bleeding
- Injury to surrounding structures
- Allergic reaction to contrast dye
- Displacement of the new catheter
- Potential need for additional intervention if complications arise
Benefits
- Restored or improved drainage, leading to reduced infection risk and enhanced healing.
- Immediate relief from symptoms associated with blocked or malfunctioning catheters.
- Increased comfort and fewer complications related to drainage issues.
Recovery
- Patients are usually monitored for a short time after the procedure.
- Instructions for catheter care and site hygiene will be provided.
- Normal activities can typically be resumed within a day or two, depending on the individual case.
- Follow-up appointments may be necessary to ensure proper catheter function and position.
Alternatives
- Surgical placement of a new drainage tube.
- Conservative management with medication and observation, though this may not be effective for all patients.
- Each alternative comes with its own set of risks and benefits, which should be discussed with a healthcare provider.
Patient Experience
During the procedure, patients may feel slight pressure or discomfort at the insertion site. Post-procedure, mild soreness or tenderness is common and can be managed with pain relief measures as needed. Patients can expect to feel improvement in symptoms related to the drainage issue shortly after the procedure.