37248 Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein

Name of the Procedure:

Transluminal Balloon Angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation within the same vein; initial vein.

Common Name(s):

• Balloon Angioplasty
• Percutaneous Transluminal Angioplasty (PTA)

Summary

Balloon Angioplasty is a medical procedure used to open up blocked or narrowed veins. It involves the insertion of a small balloon into the vein, which is then inflated to widen the vein and improve blood flow. All necessary imaging and radiological supervision are included in the procedure to ensure accuracy and safety.

Purpose

• Medical Condition: It is usually performed to treat conditions where veins become narrowed or blocked, affecting blood flow.
• Goals: The primary goal is to restore normal blood flow through the vein, thereby alleviating symptoms and preventing potential complications such as blood clots or venous insufficiency.

Indications

• Symptoms like leg pain, swelling, or cramps due to poor blood flow.
• Chronic venous insufficiency.
• Deep vein thrombosis.
• Patients who have not responded adequately to conservative treatments such as medications and lifestyle changes.

Preparation

• Fasting: Patients may be required to fast for several hours before the procedure.
• Medications: Certain medications, especially blood thinners, might need to be adjusted or stopped.
• Diagnostics: Pre-procedure imaging tests, like Doppler ultrasound, may be necessary to locate the affected vein.

Procedure Description

1. Anesthesia: Local anesthesia is typically used to numb the area.
2. Incision: A small incision is made to access the vein.
3. Catheter Insertion: A catheter with a deflated balloon at its tip is inserted into the vein.
4. Imaging: Imaging techniques such as fluoroscopy are used to guide the catheter to the narrowed section of the vein.
5. Balloon Inflation: The balloon is inflated to widen the vein.
6. Balloon Deflation: The balloon is then deflated and removed.
7. Closure: The incision site is closed and bandaged.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

It is usually performed in a hospital, outpatient clinic, or a specialized surgical center.

Personnel

• Interventional Radiologist or Vascular Surgeon
• Nurses
• Radiologic Technologist
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common Risks: Bruising, swelling, or bleeding at the incision site.
• Rare Complications: Blood vessel damage, infection, allergic reaction to contrast dye, blood clots, or re-narrowing of the vein.

Benefits

• Improved blood flow.
• Relief from symptoms such as pain and swelling.
• Reduced risk of complications associated with poor blood circulation.

Recovery

• Post-Procedure Care: Rest is recommended for a few hours. The incision site should be kept clean and dry.
• Recovery Time: Most patients can resume normal activities within a few days.
• Follow-Up Appointments: Regular check-ups to monitor vein health and ensure the treated vein remains open.

Alternatives

• Medication: Blood thinners or anticoagulants to manage blood clots.
• Compression Stockings: To improve blood flow in the legs.
• Surgical Options: In more severe cases, vein bypass surgery might be considered.

Pros and Cons: Balloon angioplasty is minimally invasive with quicker recovery compared to surgical options but may be less suitable for highly complex vein blockages.

Patient Experience

• During the Procedure: Patients may feel some pressure but should not experience significant pain due to local anesthesia.
• After the Procedure: Mild discomfort at the incision site is common, and pain management options like over-the-counter pain relievers can be used.
• Comfort Measures: Patients can expect supportive care from the healthcare team to ensure comfort and address any concerns.