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Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Angioscopy (noncoronary vessels or grafts) during therapeutic intervention

Summary

Angioscopy is a minimally invasive medical procedure used to visualize the inside of blood vessels or grafts that are not part of the coronary artery system. This procedure is performed in conjunction with another therapeutic intervention to provide real-time imaging and guidance.

Purpose

Angioscopy addresses vascular problems such as blockages, plaques, or abnormalities in noncoronary vessels or grafts. It aims to provide a detailed visual assessment to guide treatment, improving the accuracy and effectiveness of the intervention.

Indications

  • Blockages in peripheral arteries.
  • Suspicion of vascular graft issues.
  • Assessment of vascular anomalies.
  • Verification of other therapeutic procedures.
  • Patients with peripheral artery disease who are undergoing specific treatments.

Preparation

  • Fasting for 6-8 hours prior to the procedure.
  • Adjustments to certain medications as advised by the physician.
  • Blood tests, ultrasound, or other diagnostic imaging might be required before the angioscopy.

Procedure Description

  1. The patient is positioned on a procedure table.
  2. Sedation or local anesthesia is administered to ensure patient comfort.
  3. A catheter with an attached miniature camera is inserted through a small incision and navigated to the target vessel or graft.
  4. The camera transmits live images to a monitor, allowing the physician to visualize the interior of the vessel.
  5. Any therapeutic interventions, such as the removal of blockages or repair of grafts, are performed with the guidance of the angioscopic images.
  6. The catheter is carefully withdrawn, and the incision is closed.

Duration

Typically, the procedure takes about 1-2 hours but can vary depending on the complexity of the case.

Setting

Angioscopy is performed in a hospital or surgical center equipped for advanced vascular procedures.

Personnel

  • Vascular surgeon or interventional radiologist
  • Nurses
  • Anesthesiologist or sedation specialist
  • Surgical technicians

Risks and Complications

  • Infection at the incision site
  • Bleeding or hematoma
  • Vascular injury
  • Reaction to anesthesia or sedatives
  • Rarely, embolism or thrombosis

Benefits

  • Accurate diagnosis and treatment of vascular issues.
  • Minimally invasive with less recovery time compared to open surgery.
  • Real-time imaging for precise intervention.

Recovery

  • Monitoring in a recovery area for a few hours post-procedure.
  • Pain or discomfort management as needed.
  • Instructions on activities, wound care, and medications.
  • Follow-up appointments to monitor recovery and effectiveness of the intervention.
  • Most patients can resume normal activities within a few days.

Alternatives

  • Angiography
  • Magnetic Resonance Angiography (MRA)
  • Computed Tomography Angiography (CTA)
  • Open surgical procedures
  • Each alternative has its own risks and benefits, which should be discussed with the healthcare provider.

Patient Experience

During the procedure, patients will likely feel minimal discomfort due to anesthesia or sedation. Post-procedure, there may be some soreness or bruising at the insertion site. Pain management and comfort measures will be provided to ensure a smooth recovery process.

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