Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty
CPT4 code
Name of the Procedure:
Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty
Common Name(s): Transluminal angioplasty, femoral-popliteal angioplasty
Summary
Transluminal angioplasty is a minimally invasive procedure to widen narrowed or blocked arteries in the femoral and popliteal regions (thigh and knee) using a catheter and a balloon.
Purpose
This procedure is used to treat peripheral artery disease (PAD), which causes reduced blood flow to the legs. The goal is to relieve symptoms like pain and improve blood flow to the affected areas, enhancing mobility and quality of life.
Indications
- Claudication (leg pain) during walking
- Non-healing ulcers or sores on the legs
- Critical limb ischemia
- Rest pain in the legs
Preparation
- Fasting for 6-8 hours before the procedure
- Stopping certain medications like blood thinners as advised by the doctor
- Blood tests and imaging studies such as an ultrasound or angiography to assess the extent of the blockage
Procedure Description
- Anesthesia: Local anesthesia with possible sedation.
- Access Point: A small incision is made in the groin area.
- Catheter Insertion: A catheter is threaded through the artery to the site of the blockage.
- Balloon Angioplasty: A small balloon at the tip of the catheter is inflated to widen the artery.
- Assessment: The artery is assessed for improved blood flow.
- Additional Treatments: Sometimes a stent (a small mesh tube) is placed to keep the artery open.
Duration
Typically between 1-3 hours
Setting
Performed in a hospital, particularly in the catheterization lab or an interventional radiology suite.
Personnel
- Vascular surgeon or interventional radiologist
- Nurses
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Bleeding or hematoma at the insertion site
- Infection
- Blockage reoccurrence (restenosis)
- Blood clots
- Artery damage or rupture
- Allergic reaction to contrast dye
Benefits
- Relieves symptoms like leg pain and cramping
- Improves blood flow and healing of ulcers
- Enhances mobility and quality of life
- Minimally invasive with quicker recovery
Recovery
- Monitoring in a recovery area for several hours post-procedure
- Instructions to keep the incision site clean
- Avoiding strenuous activities for a few days
- Follow-up appointments for monitoring
Alternatives
- Medication management (e.g., antiplatelets, statins)
- Open surgical bypass
- Endarterectomy (removal of plaque from the artery)
Pros:
- Medication: Less invasive, fewer immediate risks.
- Open surgery: Effective for severe blockages.
Cons:
- Medication: May not be sufficient for severe PAD.
- Open surgery: More invasive, longer recovery time.
Patient Experience
During the procedure, patients may feel some pressure but generally minimal pain. Post-procedure, there might be some soreness at the insertion site. Pain management includes over-the-counter pain relievers and keeping the leg elevated to reduce swelling.