Repositioning of previously placed central venous catheter under fluoroscopic guidance
CPT4 code
Name of the Procedure:
Repositioning of Previously Placed Central Venous Catheter under Fluoroscopic Guidance
Summary
This procedure involves the adjustment of a central venous catheter (CVC) that's already been placed in the body. Utilizing fluoroscopic imaging, doctors can accurately reposition the catheter to ensure it functions properly.
Purpose
This procedure is performed to correct the positioning of a central venous catheter that may have shifted from its intended placement. The goal is to restore optimal function of the catheter, thereby ensuring proper delivery of medications or nutrients, as well as effective blood sampling.
Indications
- Misplacement or migration of the central venous catheter
- Poor functioning of the catheter
- Difficulty in administering medications or fluids
- Inability to draw blood samples
- Specific patient factors such as changes in body habitus
Preparation
- Patients may be advised to fast for a few hours prior to the procedure.
- Current medications should be reviewed with the healthcare team, with possible adjustments or temporary discontinuation of certain drugs.
- Imaging studies or other diagnostic tests may be conducted to assess the current position of the catheter.
Procedure Description
- The patient is positioned on the fluoroscopy table.
- Sterile techniques are employed to clean and prepare the insertion site.
- Local anesthesia may be applied to numb the area around the catheter site.
- A fluoroscope, an imaging device that provides real-time X-ray images, is used to guide the repositioning.
- The catheter is carefully adjusted to the correct position while being continuously monitored by the fluoroscopic images.
- The final position is confirmed, and the site is securely dressed.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital's radiology or interventional suite.
Personnel
- Interventional radiologist or a trained physician
- Radiologic technologist
- Nursing staff
- Possible involvement of an anesthesiologist for sedation
Risks and Complications
- Infection at the catheter site
- Bleeding or hematoma formation
- Damage to blood vessels
- Risk of catheter malfunction or dislodgement
- Exposure to a small amount of ionizing radiation
- Rarely, reactions to contrast material used during fluoroscopy
Benefits
Proper repositioning ensures optimal catheter function, allowing for effective administration of medications, fluids, and easy blood sampling. Benefits are realized immediately post-procedure.
Recovery
- Patients may be monitored for a short duration after the procedure for any immediate complications.
- The catheter site should be kept clean and dry, following specific care instructions provided.
- Regular follow-up appointments may be necessary to monitor the catheter’s function.
Alternatives
- Removal and insertion of a new central venous catheter
- Consideration of peripheral venous access or alternative vascular access methods
- Each alternative has its own set of pros and cons, including invasiveness, recovery time, and suitability based on patient condition.
Patient Experience
- Patients may feel pressure or mild discomfort during the catheter adjustment.
- Post-procedure pain is usually minimal and can be managed with over-the-counter pain relief if necessary.
- Anxiety or stress can be alleviated with comfort measures and detailed explanations by the healthcare team.