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Transcatheter therapy, embolization, any method, radiological supervision and interpretation

CPT4 code

Name of the Procedure:

Transcatheter Therapy, Embolization, any method, Radiological Supervision and Interpretation.

Summary

Transcatheter embolization is a minimally invasive procedure where a catheter is used to deliver materials that block blood vessels. This technique is guided by imaging technologies to ensure accurate placement and effectiveness.

Purpose

Transcatheter embolization is typically used to stop bleeding, reduce blood flow to a tumor, or obliterate abnormal vascular structures. It aims to mitigate complications from excessive blood flow, pain, or growth of tumors.

Indications

  • Uncontrolled hemorrhage or severe bleeding
  • Tumors with high blood supply
  • Vascular malformations or aneurysms
  • Post-surgical complications involving blood vessels

Patients who are unsuitable for surgical interventions due to health conditions or who have not responded to other treatments may also be indicated.

Preparation

  • Fasting for at least 6 hours before the procedure
  • Discontinuation of certain medications (e.g., blood thinners) as advised by the doctor
  • Pre-procedure blood tests and imaging studies, such as an ultrasound or CT scan

Procedure Description

  1. The patient is positioned, and the site of catheter insertion is cleaned and sterilized.
  2. Local anesthesia or sedation is administered.
  3. A small incision is made, and a catheter is inserted into a blood vessel, usually in the groin.
  4. Through radiological guidance, the catheter is navigated to the target blood vessel.
  5. Embolic agents (e.g., coils, particles, glue) are delivered through the catheter to block the affected vessel.
  6. The catheter is then removed, and the incision site is closed with a bandage.

Duration

The procedure typically takes 1-3 hours, depending on complexity.

Setting

This procedure is usually performed in a hospital's interventional radiology suite.

Personnel

  • Interventional Radiologist
  • Radiologic Technologists
  • Nurses
  • Anesthesiologist (if general anesthesia is required)

Risks and Complications

  • Infection at the insertion site
  • Allergic reaction to contrast dye
  • Blood vessel damage or dissection
  • Non-target embolization leading to unintended tissue damage
  • Post-embolization syndrome (fever, pain, nausea)

Benefits

The primary benefit is targeted treatment with minimal invasiveness, leading to quicker recovery and reduced overall risk compared to open surgery. Benefits can be realized almost immediately in cases of bleeding control or within weeks for tumor size reduction.

Recovery

  • Monitoring in the recovery area for several hours post-procedure
  • Pain management with prescribed medications
  • Limited physical activity for a few days
  • Follow-up appointments to assess efficacy and address any complications

Alternatives

  • Surgical intervention or resection
  • Medications to manage symptoms
  • Radiation therapy in the case of certain tumors Each alternative has its own pros and cons related to invasiveness, recovery time, and effectiveness.

Patient Experience

During the procedure, the patient may feel minimal discomfort due to local anesthesia. Mild soreness at the insertion site and feelings of fatigue are common post-procedure. Pain and discomfort are usually managed with prescribed medications, and most patients can resume normal activities within a week.

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