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Alcohols

CPT4 code

Name of the Procedure:

Alcohol Ablation (also known as Percutaneous Ethanol Injection or Alcohol Injection Therapy)

Summary

Alcohol ablation is a minimally invasive procedure in which ethanol (alcohol) is injected directly into an abnormal growth or tissue, such as a tumor. The alcohol causes the targeted cells to dehydrate and die, shrinking the unwanted tissue.

Purpose

Alcohol ablation is used to treat small tumors, particularly in the liver, thyroid, and parathyroid glands. It aims to reduce or eliminate the tumor and its symptoms, potentially avoiding the need for more invasive surgeries.

Indications

  • Presence of small liver tumors or metastases not amenable to surgical removal.
  • Small, benign thyroid or parathyroid nodules causing symptoms.
  • Patient suitability based on the size and location of the tumor, overall health, and other medical conditions.

Preparation

  • Patients may need to fast for a specified period before the procedure.
  • Pre-procedure imaging studies like ultrasound or CT scans to map the tumor's size and location.
  • Medication adjustments as directed, especially blood thinners or anticoagulants.
  • Pre-procedure blood tests to ensure normal clotting functions.

Procedure Description

  1. The patient lies on a procedure table and the target area is sterilized.
  2. Local anesthesia is administered to numb the area.
  3. Using imaging guidance (ultrasound or CT), the physician inserts a fine needle into the tumor.
  4. Ethanol is injected through the needle directly into the tumor.
  5. The needle is removed, and a small bandage is applied to the puncture site.
  6. The patient is monitored for any immediate reactions or complications post-injection.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the size and location of the tumor.

Setting

Alcohol ablation is performed in a hospital setting or an outpatient clinic equipped with imaging technology.

Personnel

  • Interventional radiologist or a trained physician.
  • Nurses or medical technicians assisting with the procedure and monitoring.

Risks and Complications

  • Mild risks include pain at the injection site, minor bleeding, and bruising.
  • Rare but serious risks include infection, damage to nearby organs, or unintended alcohol leakage.

Benefits

  • Minimally invasive alternative to surgery.
  • Can successfully shrink or eradicate small tumors, alleviating symptoms.
  • Recovery time is generally shorter than surgical options.

Recovery

  • Patients usually rest in a recovery area briefly before being discharged.
  • Rest and limited activity may be advised for 24 hours post-procedure.
  • Follow-up imaging and appointments to monitor treatment efficacy.

    Alternatives

  • Surgical removal of the tumor.
  • Radiofrequency ablation or microwave ablation.
  • Chemotherapy or radiation therapy, depending on the tumor type and stage.
  • The choice of alternative depends on the specific medical condition and patient factors.

Patient Experience

  • Expect local discomfort or pain during injection, managed with local anesthesia.
  • Some post-procedure soreness or swelling, typically mild and manageable with over-the-counter pain relievers.
  • Most patients can resume normal activities within a day, with specific post-care instructions to follow.

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