Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a s
CPT4 code
Name of the Procedure:
Endovenous Ablation Therapy of Incompetent Vein, Extremity (Common names: Vein Glue Therapy, Cyanoacrylate Glue for Veins)
Summary
In endovenous ablation therapy, a special medical adhesive is delivered through a catheter to a problematic vein in the leg, effectively sealing it off. This minimally invasive procedure is guided by imaging techniques and does not require invasive surgery.
Purpose
Endovenous ablation therapy addresses vein incompetence, where veins in the extremities can't efficiently carry blood back to the heart. The primary goal is to eliminate unhealthy veins, alleviate symptoms like pain and swelling, and improve overall circulation.
Indications
- Varicose veins
- Chronic venous insufficiency
- Persistent leg pain
- Swelling, heaviness, or aching in the legs
- Skin changes or ulcers due to poor vein function
Preparation
- Patients may be advised to fast for a few hours before the procedure.
- Discontinuing certain medications like blood thinners may be necessary.
- A pre-procedure ultrasound will often be performed to map out the veins.
Procedure Description
- The patient lies comfortably, and the area is cleaned and sterilized.
- Using ultrasound guidance, a catheter is inserted percutaneously into the targeted vein.
- A medical adhesive (cyanoacrylate) is then delivered via the catheter to seal the vein.
- The catheter is carefully removed, and the entry point is bandaged.
Tools and Equipment:
- Ultrasound device
- Catheter
- Cyanoacrylate adhesive
Anesthesia:
Local anesthesia is typically used at the catheter insertion site.
Duration
The procedure usually takes about 30 to 60 minutes.
Setting
This procedure is performed in an outpatient clinic or a specialized vein treatment center.
Personnel
- Interventional radiologist or vascular surgeon
- Nurses
- Ultrasound technician
Risks and Complications
- Local infection or bruising at the catheter insertion site
- Allergic reaction to the adhesive
- Deep vein thrombosis (rare)
- Mild pain or discomfort after the procedure
Benefits
- Relief of symptoms associated with vein incompetence
- Minimally invasive with no need for general anesthesia
- Quick recovery time
- Immediate improvement in circulation and symptom relief within days
Recovery
- Patients can usually resume normal activities within 24-48 hours.
- Compression stockings might be recommended post-procedure.
- Follow-up ultrasound to ensure the vein is successfully sealed.
Alternatives
- Sclerotherapy: Injecting a solution to collapse the vein
- Endovenous laser or radiofrequency ablation: Using heat to close the vein
- Open vein surgery (vein stripping): Removing the vein through incisions
Pros and Cons:
- Alternatives might involve longer recovery times or increased discomfort.
- The choice of treatment may depend on the vein's size, location, and patient's medical condition.
Patient Experience
- Slight pressure or discomfort during catheter insertion.
- Mild pain or soreness post-procedure, manageable with over-the-counter pain relief.
- Most patients can walk immediately and return to daily activities quickly.
By fully understanding the procedure, associated risks, benefits, and recovery process, patients can be well-prepared to undergo endovenous ablation therapy with confidence.