75962 Transluminal balloon angioplasty, peripheral artery other than renal, or other visceral artery, iliac or lower extremity, radiological supervision and interpretation

Name of the Procedure:

Transluminal Balloon Angioplasty, Peripheral Artery Other Than Renal, or Other Visceral Artery, Iliac or Lower Extremity, Radiological Supervision and Interpretation. Commonly known as Peripheral Angioplasty.

Summary

Peripheral Angioplasty is a minimally invasive procedure used to treat narrowed or blocked arteries in the peripheral regions of the body, such as the legs or iliac arteries, using a small balloon catheter that is inflated to open up the artery.

Purpose

The procedure addresses peripheral artery disease (PAD) caused by the buildup of fatty deposits on the artery walls. The goal is to restore proper blood flow, relieve symptoms like pain or cramping, and improve the patient's overall mobility and quality of life.

Indications

• Intermittent claudication (pain during walking)
• Rest pain (pain at rest)
• Non-healing ulcers or wounds on the lower extremities
• Gangrene
• Poor blood flow to the legs or pelvis
• Severe blockages that could lead to limb loss

Preparation

• Fasting for 6-8 hours prior to the procedure
• Adjusting or stopping certain medications as advised by the doctor
• Blood tests and imaging studies (e.g., ultrasound, angiogram) to assess the location and severity of artery blockage

Procedure Description

1. The patient is positioned on an X-ray table, and local anesthesia or mild sedation may be administered.
2. A catheter is inserted through a small incision in the groin or arm and guided to the affected artery.
3. Once the catheter reaches the blockage, a balloon at its tip is inflated to push the plaque against the artery walls, widening the artery.
4. The balloon is then deflated and removed.
5. A stent (a small wire mesh tube) may be placed to keep the artery open.
6. The catheter is withdrawn, and the incision site is closed.

Tools: Fluoroscope (X-ray machine), balloon catheter, guide wire, stent (if needed) Anesthesia: Local anesthesia or mild sedation

Duration

Typically, 1-2 hours, depending on the complexity of the blockage.

Setting

Hospital or specialized outpatient clinic equipped with a catheterization lab.

Personnel

Interventional radiologist or vascular surgeon, radiologic technologists, nurses, anesthesiologist or sedation nurse.

Risks and Complications

• Bleeding or infection at the insertion site
• Artery damage or rupture
• Blood clots
• Allergic reaction to contrast dye
• Kidney damage from dye used in imaging
• Restenosis (re-narrowing of the artery)

Benefits

• Improved blood flow and relief from PAD symptoms
• Reduced risk of severe complications like limb amputation
• Enhanced ability to engage in physical activities and improved overall quality of life Benefits are typically realized within days to weeks after the procedure.

Recovery

• Monitoring for several hours post-procedure to ensure there are no complications
• Instructions on how to care for the incision site
• Avoid strenuous activities for a few days
• Follow-up appointments to monitor artery condition
• Patients can usually resume normal activities within a week

Alternatives

• Medication management (e.g., antiplatelet drugs, statins)
• Lifestyle changes (diet, exercise, smoking cessation)
• Other minimally invasive procedures (e.g., atherectomy)
• Bypass surgery for severe cases Each alternative has its pros and cons, balancing between invasiveness, effectiveness, recovery time, and patient suitability.

Patient Experience

Patients may feel mild discomfort during catheter insertion and inflation of the balloon. Post-procedure, soreness at the incision site is common. Pain management typically includes over-the-counter pain relievers. Most patients can go home the same day or after an overnight stay, depending on their overall condition and response to the procedure.