Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up ca
CPT4 code
Name of the Procedure:
Transcatheter Therapy, Arterial or Venous Infusion for Thrombolysis (Non-coronary)
Summary
Transcatheter therapy for thrombolysis involves using a catheter to deliver clot-dissolving medication directly into a blocked artery or vein (excluding coronary arteries). This procedure typically includes radiological supervision and interpretation and may require continued treatment over subsequent days.
Purpose
Transcatheter therapy addresses blood clots in arteries or veins that are obstructing blood flow. The procedure aims to dissolve the clot, restore normal circulation, and prevent potential complications such as tissue damage or organ failure.
Indications
- Deep vein thrombosis (DVT)
- Pulmonary embolism (PE)
- Peripheral arterial occlusion
- Acute limb ischemia
Any significant non-coronary thrombotic event
Patients suitable for this procedure often present severe symptoms of blockage, such as swelling, pain, or sudden shortness of breath.
Preparation
- Patients may need to fast for several hours before the procedure.
- Adjustments in current medications may be necessary, particularly blood thinners.
- Diagnostic imaging (e.g., ultrasound, CT scans) is performed to confirm clot location.
Procedure Description
- The patient is positioned and provided with local anesthesia at the catheter insertion site.
- A small incision is made to insert a catheter into the affected artery or vein.
- Using real-time imaging guidance, the catheter is navigated to the clot location.
- Thrombolytic medication is infused through the catheter directly into the blockage to dissolve the clot.
The procedure may include continuous infusion over subsequent days, with periodic radiological follow-up to monitor progress.
Equipment used includes catheters, imaging technology (e.g., fluoroscopy), and thrombolytic drugs.
Duration
The initial procedure typically takes 1-2 hours. Continued treatment and follow-up may extend over several days.
Setting
The procedure is performed in a hospital's interventional radiology suite or an operating room equipped with imaging capabilities.
Personnel
- Interventional radiologist or vascular surgeon
- Radiology technicians
- Nurses specialized in interventional procedures
- Anesthesiologist (if sedation or general anesthesia is required)
Risks and Complications
Common risks:
- Bleeding at the insertion site
- Infection
- Allergic reaction to the medication
Rare risks:
- Damage to blood vessels
- Hemorrhage
- Embolization of the clot to other parts of the body
Complications are managed by the medical team through close monitoring and appropriate interventions.
Benefits
- Rapid symptom relief
- Restored blood flow
- Reduction in the likelihood of tissue damage or organ complications
- Improved quality of life
Benefits often become noticeable within hours to a few days after the procedure.
Recovery
- Patients may remain hospitalized for monitoring during continued treatment.
- Regular follow-up imaging to assess treatment success.
- Instructions may include limited physical activity to prevent further clot formation.
- Follow-up appointments with the treating physician.
Alternatives
- Systemic thrombolysis (medication administered through an IV)
- Surgical thrombectomy (surgical removal of the clot)
- Anticoagulant medication
- Compression stockings and physical therapy
Patient Experience
During the procedure:
- Mild discomfort at the insertion site
- Minimal pain due to local anesthesia
- Real-time monitoring ensures patient comfort
After the procedure:
- Some soreness or bruising at the catheter site
- Most patients report significant symptom relief within days
- Pain management typically involves over-the-counter pain relievers and comfort measures such as rest and ice packs.