Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for p
CPT4 code
Name of the Procedure:
Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed
Summary
This procedure is a minimally invasive technique to restore blood flow in the tibial or peroneal artery located in the lower leg. It involves placing a stent and performing angioplasty to widen and support the artery.
Purpose
The primary goal is to improve blood circulation in the lower extremities. It is typically done to alleviate symptoms of peripheral artery disease (PAD) such as pain, cramping, and poor wound healing, and to prevent further complications like ischemia.
Indications
- Patients with peripheral artery disease (PAD)
- Critical limb ischemia
- Severe claudication unresponsive to other treatments
- Non-healing ulcers or wounds on the lower legs and feet
Preparation
- Fasting for 6 to 8 hours before the procedure
- Adjusting medications as advised by the physician, especially blood thinners
- Pre-procedure imaging tests like ultrasound or MRI
Procedure Description
- Insertion: A small incision is made in the groin or leg to introduce a catheter.
- Navigation: Using imaging guidance, the catheter is navigated to the area of the blocked artery.
- Angioplasty: A balloon is inflated inside the artery to widen it.
- Stent Placement: A stent is placed to keep the artery open.
- Completion: The catheter is removed, and the incision site is closed.
Duration
Approximately 1 to 2 hours.
Setting
The procedure is usually performed in a hospital's catheterization lab or an outpatient surgical center.
Personnel
- Interventional radiologist or vascular surgeon
- Surgical nurses
- Anesthesiologist or nurse anesthetist
- Radiologic technologist
Risks and Complications
- Bleeding or hematoma at the incision site
- Infection
- Artery damage
- Allergic reaction to contrast dye
- Blood clots
- Restenosis (re-narrowing of the artery)
Benefits
- Improved blood flow to the affected limb
- Relief from pain and cramping
- Enhanced wound healing
- Reduced risk of limb loss
Recovery
- Monitoring in a recovery area for a few hours
- Avoiding strenuous activities for a few days
- Keeping the incision site clean and dry
- Follow-up appointment within a week to check on healing and function
Alternatives
- Medications to manage PAD symptoms
- Supervised exercise programs
- Other surgical options like bypass surgery
- Lifestyle changes, including smoking cessation and diet modifications
Patient Experience
- Mild discomfort during positioning and local anesthesia
- Pressure or a slight burning sensation during balloon inflation
- Mild pain at the incision site post-procedure, manageable with pain relief medications
- Ability to walk shortly after the procedure, but with some restrictions on activity