Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel
CPT4 code
Name of the Procedure:
Transluminal Balloon Angioplasty, Percutaneous; Brachiocephalic Trunk or Branches (Each Vessel)
Summary
Transluminal balloon angioplasty is a minimally invasive procedure used to open up narrowed or blocked arteries in the brachiocephalic trunk or its branches. A tiny balloon attached to a catheter is inflated at the site of the blockage to widen the artery and restore normal blood flow.
Purpose
The primary purpose of this procedure is to treat arterial stenosis (narrowing) or blockages in the brachiocephalic trunk or its branches, which can lead to reduced blood flow to the head, neck, or arms. By widening the artery, the procedure aims to alleviate symptoms, improve circulation, and prevent complications such as stroke or tissue damage.
Indications
- Symptoms such as dizziness, headaches, or numbness in the arms due to poor circulation.
- Diagnostic imaging showing significant narrowing or blockage in the brachiocephalic trunk or its branches.
- Patients with risk factors for stroke or other cardiovascular events.
Preparation
- Patients may need to fast for several hours before the procedure.
- Medications may need to be adjusted, especially blood thinners.
- Pre-procedure tests such as blood work, EKG, or imaging studies (CT scan, MRI, or angiography) are typically required.
Procedure Description
- The patient is given local anesthesia or mild sedation to ensure comfort.
- A catheter is inserted into a blood vessel, usually in the groin or arm, and guided to the site of the blockage using imaging technology.
- Once positioned correctly, a small balloon at the end of the catheter is inflated to widen the artery.
- The balloon is then deflated and removed, and in some cases, a stent may be placed to keep the artery open.
- The catheter is removed, and the insertion site is sealed.
Duration
The procedure typically takes about 1 to 2 hours, though this can vary depending on the complexity of the case.
Setting
Transluminal balloon angioplasty is usually performed in a hospital setting, specifically in a cardiac catheterization laboratory or an interventional radiology suite.
Personnel
- Interventional cardiologist or vascular surgeon
- Nurses specialized in interventional procedures
- Radiologic technologists
- Anesthesiologist or nurse anesthetist if sedation or general anesthesia is used
Risks and Complications
- Bleeding or hematoma at the catheter insertion site
- Artery damage or rupture
- Infection
- Blood clot formation
- Re-narrowing of the artery (restenosis)
- Rarely, stroke or other serious cardiovascular events
Benefits
- Improved blood flow to the affected areas
- Relief from symptoms such as dizziness and arm numbness
- Reduced risk of stroke and other complications
- Minimally invasive, with quicker recovery times compared to open surgery
Recovery
- Patients are usually monitored for a few hours post-procedure and may stay overnight in the hospital.
- Instructions include avoiding strenuous activities for a few days.
- Follow-up appointments to monitor the success of the procedure and check for any complications.
- Patients may be advised to take antiplatelet medications to prevent blood clots.
Alternatives
- Medical management with medications to control symptoms and risk factors.
- Surgical options such as endarterectomy, where the artery is surgically opened to remove the blockage.
- Pros and cons: Medication may not be as immediately effective; surgery is more invasive with a longer recovery time.
Patient Experience
- During the procedure, patients may feel some pressure but should not feel pain due to local anesthesia or sedation.
- Post-procedure, discomfort at the catheter insertion site is possible but manageable with pain relief measures.
- Patients can generally resume normal activities within a few days, but need to follow specific instructions to ensure proper healing.