Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (List in addition to code for initial second or third order vessel as appropriat
CPT4 code
Name of the Procedure:
Selective Catheter Placement, Arterial System; Additional Second Order, Third Order, and Beyond, Abdominal, Pelvic, or Lower Extremity Artery Branch
Summary
This procedure involves placing a catheter directly into a specific branch of an artery in the abdomen, pelvis, or lower extremity. It is typically done to deliver medications, obtain diagnostic images, or provide specific treatments to a targeted area.
Purpose
The procedure addresses circulatory issues or diseases affecting the abdominal, pelvic, or lower extremity arteries. It aims to improve blood flow, deliver medications, or acquire precise diagnostic information.
Indications
- Peripheral artery disease (PAD)
- Aneurysms
- Vascular malformations
- Pre-surgical planning or intervention
- Targeted chemotherapy for cancer treatment
Preparation
- Fasting for 6-8 hours before the procedure
- Adjusting current medications as directed by a healthcare provider
- Blood work and other diagnostic tests, such as ultrasound or CT scan
Procedure Description
- Local anesthesia is applied to the insertion site.
- A small incision is made, typically in the groin or arm.
- A catheter is guided through the arterial system to the target artery branch using fluoroscopic imaging for guidance.
- Contrast dye may be injected to obtain clear images.
- The catheter is positioned precisely in the second, third, or beyond order arterial branch for the specific intervention required.
- Once the procedure is completed, the catheter is carefully removed, and the incision site is closed and dressed.
Duration
The procedure generally takes between 1-2 hours, depending on complexity.
Setting
Typically performed in a hospital's interventional radiology suite or a specialized outpatient center.
Personnel
- Interventional radiologist or vascular surgeon
- Radiology technologist
- Nurse
- Anesthesiologist (if general anesthesia is required)
Risks and Complications
- Bleeding or hematoma at the insertion site
- Infection
- Allergic reaction to contrast dye
- Injury to the blood vessel
- Blood clots
- Contrast-induced nephropathy
Benefits
- Precise treatment of vascular issues
- Improved diagnostic accuracy
- Minimally invasive with shorter recovery times
- Targeted delivery of treatment
Recovery
- Monitoring in the recovery room for a few hours
- Keeping the insertion site clean and dry
- Avoiding strenuous activity for 24-48 hours
- Follow-up appointments to monitor progress
Alternatives
- Non-selective catheter placement
- Traditional open surgery
- Medications for symptom relief
- Lifestyle changes and physical therapy Each alternative has its own set of risks, benefits, and recovery times.
Patient Experience
During the procedure, patients may feel the initial slight sting of the local anesthetic and some pressure but should experience minimal discomfort. After the procedure, mild soreness or bruising at the insertion site is common. Pain management and comfort measures will be provided.