Transluminal balloon angioplasty, percutaneous; renal or visceral artery
CPT4 code
Name of the Procedure:
Transluminal Balloon Angioplasty, Percutaneous; Renal or Visceral Artery
Common Names: Angioplasty for renal/visceral artery, Balloon angioplasty
Summary
Transluminal balloon angioplasty for the renal or visceral artery is a minimally invasive procedure aimed at opening narrowed or blocked arteries that supply blood to the kidneys or other abdominal organs. A tiny balloon is used to expand the artery and improve blood flow.
Purpose
The procedure addresses conditions such as renal artery stenosis or blockages in visceral arteries, which can lead to high blood pressure, reduced kidney function, or impaired blood supply to abdominal organs. The primary goals are to restore adequate blood flow, improve organ function, and alleviate symptoms associated with reduced blood supply.
Indications
- Renal artery stenosis causing high blood pressure or kidney dysfunction
- Visceral artery stenosis/occlusion leading to abdominal pain or organ ischemia
- Symptoms such as resistant hypertension, kidney failure, severe abdominal pain, or unexplained weight loss
- Patients who do not respond to medication or other treatments
Preparation
- Patients may need to fast for several hours before the procedure.
- Certain medications, especially blood thinners, may need to be adjusted.
- Pre-procedure testing may include blood tests, kidney function tests, and imaging studies like an angiogram or ultrasound.
Procedure Description
- The patient is given local anesthesia and possibly mild sedation.
- A catheter is inserted into a blood vessel, typically in the groin.
- The catheter is guided through the bloodstream to the narrowed renal or visceral artery.
- A balloon at the catheter's tip is inflated to widen the artery, then deflated and removed.
- A stent may be placed to keep the artery open.
- The catheter is removed, and the entry point is bandaged.
Duration
The procedure typically takes 1 to 2 hours.
Setting
The procedure is usually performed in a hospital's catheterization laboratory or an outpatient surgical center.
Personnel
- Interventional radiologist or vascular surgeon
- Nurse
- Anesthesiologist or sedation nurse
Risks and Complications
- Bleeding or hematoma at the insertion site
- Artery damage or dissection
- Kidney damage
- Contrast dye allergic reactions or induced nephropathy
- Rare risks: infection, stroke, or heart attack
Benefits
- Improved blood flow to the kidneys or abdominal organs
- Reduction in high blood pressure
- Better organ function and symptom relief
- Reduced risk of kidney failure or abdominal organ damage
Recovery
- Patients typically stay for a short observation period.
- They are advised to rest and avoid heavy lifting for a few days.
- Follow-up appointments are necessary to monitor recovery and artery status.
- Most patients return to normal activities within a week.
Alternatives
- Medication management for blood pressure or symptoms
- Lifestyle changes, such as diet and exercise
- Surgical revascularization (bypass surgery)
- Pros of angioplasty: less invasive, quicker recovery.
- Cons: not suitable for all patients, potential need for repeat procedures.
Patient Experience
- During the procedure, patients might feel slight pressure or discomfort but minimal pain due to local anesthesia.
- Post-procedure, some soreness at the catheter insertion site is common.
- Pain management can be addressed with over-the-counter pain relievers.
- Most patients resume normal activities within a few days to a week.