Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft exten
CPT4 code
Name of the Procedure:
Endovascular Repair of Iliac Artery by Deployment of an Ilio-Iliac Tube Endograft
Summary
This minimally invasive procedure involves the placement of a tube-like device (endograft) to reinforce and repair the iliac artery, often performed to treat aneurysms or blockages. It uses catheters and imaging for precise device placement.
Purpose
The primary goal is to repair damaged or diseased iliac arteries, often due to aneurysms or significant blockages. By doing so, it aims to restore normal blood flow and prevent artery rupture or further complications.
Indications
- Presence of an iliac artery aneurysm
- Significant iliac artery stenosis (narrowing) or occlusion (blockage)
- Patients with symptoms like leg pain, fatigue, or risk of artery rupture
- Suitable anatomy for endograft placement determined by pre-procedure imaging
Preparation
- Fasting for 6-12 hours before the procedure
- Discontinuation or adjustment of certain medications as advised by the doctor
- Pre-procedure imaging, such as CT angiography, to assess iliac artery anatomy
- Blood tests and ECG might be required
Procedure Description
- Anesthesia: The patient is typically under general or local anesthesia with sedation.
- Access: A small incision is made in the groin to access the femoral artery.
- Catheterization: A catheter is guided through the arteries to the iliac artery and precise measurements are taken.
- Device Placement: The ilio-iliac tube endograft is deployed within the iliac artery under fluoroscopic guidance.
- Imaging: Real-time imaging ensures proper placement and functionality of the endograft.
- Closure: The catheter and sheath are removed, and the incision is closed.
Duration
The procedure typically takes 1-3 hours.
Setting
Performed in a hospital, specifically in a catheterization lab or an operating room.
Personnel
- Vascular surgeon or interventional radiologist
- Anesthesiologist or nurse anesthetist
- Radiology technologist
- Surgical nurses and assistants
Risks and Complications
- Bleeding or hematoma at the incision site
- Infection
- Endograft leakage or misplacement
- Blood vessel injury
- Allergic reaction to contrast dye
- Kidney issues due to contrast dye
Benefits
- Minimally invasive with shorter recovery time than open surgery
- Reduced risk of iliac artery rupture
- Improvement in blood flow potentially alleviating symptoms
Recovery
- Observation in the hospital for 1-2 days
- Pain management with prescribed medication
- Avoid strenuous activities for a few weeks
- Follow-up appointments for imaging to check endograft position
Alternatives
- Open surgical repair: more invasive with a longer recovery time
- Watchful waiting: for smaller aneurysms with regular monitoring
- Medical management: for less severe cases, involving medication and lifestyle changes
Patient Experience
During the procedure, the patient is typically sedated and should not feel pain. Post-procedure, the patient might experience some discomfort at the incision site, managed with pain relief medication. Some groin bruising or mild swelling is common, and most patients can return to normal activities within a few weeks.