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Transluminal balloon angioplasty, percutaneous; venous

CPT4 code

Name of the Procedure:

Transluminal balloon angioplasty, percutaneous; venous
(Common name: Balloon venoplasty)

Summary

Transluminal balloon angioplasty, or balloon venoplasty, is a minimally invasive medical procedure that uses a special balloon-tipped catheter to widen narrowed or obstructed veins, improving blood flow.

Purpose

This procedure addresses venous obstructions or narrowing (stenosis) that can cause symptoms like swelling, pain, or varicose veins. The goal is to enhance blood flow through the affected vein, alleviating symptoms and reducing the risk of complications such as blood clots.

Indications

  • Chronic venous insufficiency
  • Deep vein thrombosis (DVT) recovery
  • Signs of venous compression or occlusion (e.g., leg swelling, varicose veins)
  • Venous outflow obstruction due to congenital conditions

Preparation

  • Fasting for 6-8 hours before the procedure.
  • Discontinue certain medications (e.g., blood thinners) as instructed by your doctor.
  • Pre-procedure imaging tests such as an ultrasound or venogram may be required to assess the vein.

Procedure Description

  1. The patient lies on an examination table.
  2. A local anesthetic is applied to numb the puncture site.
  3. A small incision is made, and a catheter with a deflated balloon at its tip is inserted into the vein.
  4. Using live X-ray imaging (fluoroscopy), the catheter is guided to the site of narrowing.
  5. The balloon is then inflated, pressing the narrowed vein open and improving blood flow.
  6. The balloon is deflated and removed, and a small bandage is placed over the incision site.

Tools/Equipment:

  • Balloon-tipped catheter
  • Fluoroscopy machine
  • Local anesthetics

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

Performed in a hospital or outpatient clinic with a specialized interventional radiology suite.

Personnel

  • Interventional Radiologist or Vascular Surgeon
  • Nurses
  • Radiologic Technologist

Risks and Complications

  • Bleeding or bruising at the puncture site
  • Infection
  • Vein injury or rupture
  • Rare risks include blood clots and reaction to contrast dye used in imaging

Benefits

  • Improved blood circulation in the treated vein
  • Alleviation of symptoms such as pain and swelling
  • Quick recovery time compared to surgical alternatives

Recovery

  • Monitor for immediate complications in a recovery area for a few hours.
  • Rest and avoid strenuous activities for at least 24 hours.
  • Follow-up appointments to monitor vein function and overall recovery.

Alternatives

  • Medication management (e.g., anticoagulants)
  • Compression stockings
  • Surgical venous bypass or vein stripping
  • Sclerotherapy for smaller veins

Patient Experience

During the procedure, patients may feel slight pressure but usually no significant pain due to local anesthesia. Post-procedure, mild soreness or bruising at the incision site may occur, with pain managed through over-the-counter pain relievers. Comfort measures include elevated leg positioning and avoidance of heavy lifting for the first few days.

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