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Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis

CPT4 code

Name of the Procedure:

Angiography through Existing Catheter for Follow-Up Study for Transcatheter Therapy, Embolization, or Infusion (other than Thrombolysis)

Summary

Angiography through an existing catheter is a medical imaging procedure used as a follow-up to transcatheter therapies. It involves injecting a contrast dye into the blood vessels through a pre-placed catheter to visualize and assess blood flow and the effectiveness of previous treatments, such as embolization or infusion.

Purpose

This procedure is performed to evaluate the success of transcatheter therapies (e.g., tumor embolization or medication infusion) and to monitor the blood vessels for any changes or issues that may need further treatment.

Indications

  • Follow-up evaluation after transcatheter therapy.
  • Monitoring the effect of embolization on tumors or abnormal blood vessels.
  • Assessing the effectiveness of infusions, excluding thrombolytic therapy.

Preparation

  • Patients may be instructed to fast for a few hours before the procedure.
  • Medication adjustments might be necessary.
  • Blood tests and imaging studies may be required beforehand to provide baseline data.

Procedure Description

  1. Catheter Access: The procedure utilizes an existing catheter placed in a previous intervention.
  2. Contrast Injection: A contrast dye is injected through the catheter to highlight blood vessels on imaging.
  3. Imaging: X-ray or fluoroscopy is used to capture detailed images of the blood vessels.
  4. Assessment: The images are analyzed to assess blood flow and the success of previous interventions.

Tools and Equipment: Catheter, contrast dye, fluoroscopy machine, and X-ray equipment.

Anesthesia/Sedation: Mild sedation may be administered to ensure patient comfort. Local anesthesia around the catheter site might be used.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

It is usually performed in a hospital's radiology department or an outpatient surgical center.

Personnel

  • Interventional radiologist or vascular surgeon.
  • Radiology technologists.
  • Nurses and possibly an anesthesiologist.

Risks and Complications

  • Common Risks: Allergic reaction to contrast dye, minor bleeding at the catheter insertion site.
  • Rare Risks: Infection, blood vessel damage, renal complications from dye, or clot formation.

Benefits

  • Accurate assessment of treatment efficacy.
  • Minimally invasive with a quicker recovery compared to surgical evaluation.
  • Real-time visualization can guide further treatment if needed.
  • Benefits typically realized immediately upon review of imaging.

Recovery

  • Patients are usually monitored for a short period post-procedure.
  • Instructions include rest for a few hours and monitoring the catheter site for signs of infection.
  • Normal activities can often be resumed within a day, with a follow-up appointment scheduled if necessary.

Alternatives

  • Alternative Imaging: MRI or CT angiography, though these may not be adequate for follow-up assessments involving previous catheter-directed treatments.
  • Pros and Cons: Non-invasive alternatives might not provide the same level of detail for certain conditions, but they carry fewer immediate risks related to contrast dye.

Patient Experience

  • Patients might feel slight pressure or discomfort when the contrast dye is injected.
  • Minor soreness at the catheter site.
  • Pain management typically includes over-the-counter medications, and comfort measures include ensuring a calm and supportive environment.

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