Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
CPT4 code
Name of the Procedure:
Revascularization, Endovascular, Open or Percutaneous, Iliac Artery, Unilateral, Initial Vessel; with Transluminal Stent Placement(s)
Summary
This procedure involves the placement of a stent in the iliac artery to restore blood flow. It may include angioplasty, where a balloon is used to open the vessel.
Purpose
The procedure addresses blockages or narrowing in the iliac artery, which can cause poor blood flow to the legs. The goal is to improve circulation and alleviate symptoms such as pain or cramping while walking.
Indications
- Peripheral artery disease (PAD) causing significant leg pain or cramping
- Claudication (pain due to insufficient blood flow during exercise)
- Tissue damage or ulcers on the feet or legs due to poor circulation
- Failed initial less invasive treatments
Preparation
- Fasting for several hours before the procedure
- Adjusting or discontinuing certain medications, as advised by the doctor
- Pre-procedure imaging tests, such as an angiogram, to map the artery
Procedure Description
- The patient is sedated or given local anesthesia.
- A small incision is made to access the iliac artery.
- A catheter is guided through the artery to the narrowed area.
- An angioplasty balloon may be inflated to open the vessel.
- A stent is placed to keep the artery open.
- The catheter is withdrawn, and the incision is closed.
Duration
1-2 hours, depending on the complexity.
Setting
Hospital or outpatient surgical center.
Personnel
- Interventional radiologist or vascular surgeon
- Nurses
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Bleeding or bruising at the incision site
- Infection
- Blood clots
- Stent movement or blockage
- Allergic reaction to contrast dye
Benefits
- Improved blood flow to the legs
- Reduced pain and cramping
- Enhanced ability to walk and perform daily activities
- Healing of ulcers or tissue damage
Recovery
- Observation in a recovery room for a few hours
- Instructions to avoid strenuous activities for a few days
- Monitoring the incision site for signs of infection
- Follow-up appointments to check the stent and blood flow
Alternatives
- Medication to manage symptoms
- Lifestyle changes, including diet and exercise
- Non-surgical treatments like angioplasty without stent placement
- Surgical bypass of the blocked artery
Patient Experience
During the procedure, patients may feel pressure but usually not pain, thanks to anesthesia. Post-procedure, some soreness at the incision site is normal, and discomfort is managed with pain relief medications. Walking and other activities often improve soon after recovery.